Diabetes & Vision Loss

Overview

Although most people will associate diabetes mellitis with sugar and insulin, few actually realize just how devastating diabetes can be for vision. Diabetes mellitis is ranked in the top four leading causes of blindness.

Diabetes mellitis is a condition in which the body either does not produce insulin (Type 1 diabetes) or cannot properly use insulin (Type 2 diabetes). Insulin is absolutely essential for converting food into energy. Without insulin, glucose (sugar) builds up in the bloodstream, causing damage to numerous organs and tissues in the body, including the eyes.

Damage to the eyes from the effects of diabetes can take the form of any or all of the following eye conditions: diabetic retinopathy, cataracts, vitreous hemorrhage, glaucoma, and fluctuations in refractive error.

The key to preventing vision loss due to diabetes is to control glucose and insulin levels. By controlling diabetes, the risk of vision loss is significantly lower. Diabetics who have had poor control over their diabetes for a long period of time (ie. 10 years or more) are at the highest risk of developing diabetes related eye disease.

Signs & Symptoms of Diabetes

frequent urination
fatigue and/or weakness
recurrent yeast infections
tingling and/or numbness of the hands and feet
abnormally excessive thirst

Ocular Symptoms of Diabetes

blurred vision

vision fluctuations

light sensitivity

glare

abnormal color vision

blindness

Diabetic Retinopathy

Diabetic retinopathy is the term used when diabetes causes damage to the light-sensitive membrane inside the eye, the retina. Diabetic retinopathy is the complication of diabetes that most commonly leads to vision loss and blindness.

Diabetes damages small blood vessels, many of which can be found inside the eye. Damage to blood vessels causes rupture and subsequent leakage of blood. This is devastating when it occurs inside the eye.

Figure: Neovascularization in Proliferative Diabetic Retinopathy. Courtesy of EyeAtlas.com.

There are two types of diabetic retinopathy: pre-proliferative and proliferative retinopathy. In pre-proliferative diabetic retinopathy, there are signs that the retina is being starved of oxygen, but no new blood vessels have formed yet. Proliferative diabetic retinopathy occurs in 5-10% of diabetics. People with Type 1 diabetes are most at risk of developing this. Neovascularization (formation of new blood vessels) is the hallmark feature of proliferative diabetic retinopathy. See the Figure to view the appearance of neovascularization around the optic nerve head. Proliferative diabetic retinopathy has by far the most devastating impact on vision.

Diabetes and Cataracts

People with diabetes tend to develop cataracts sooner in life, and also different in nature than the typical cataracts experienced by other people. The types of cataracts that occur more often in people with diabetes are cortical cataract and subcapsular cataract.

Diabetic Retinopathy Treatment

The first line of defense against diabetic retinopathy and other diabetes-related vision loss is to maintain regular visits with your optometrist or ophthalmologist (whatever the case may be). By monitoring any changes that might be occurring in the eye, retinal changes and vision problems can be caught early, perhaps even before symptoms occur. It is also absolutely essential that people ensure that they control their diabetes as best they can.

The treatment for diabetic retinopathy is called laser photocoagulation. This involves the use of a laser to essentially “glue” blood vessels shut, preventing further neovascularization and leakage of blood. Use of laser photocoagulation actually causes damage to the retina as well, but it does prevent further vision loss that would result if the eye disease were left untreated.

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Disclaimer

The information provided by KnowYourEyes.com is intended for educational purposes only and in no way replaces the advice and diagnosis of a licensed eye care professional. KnowYourEyes.com disclaims any and all liability for injury or other damages that may result from use of the information obtained from this website.

Accu-Chek Active Diabetes Monitoring Kit

Accu-Check Diabetes Monitoring Kit comes with a Free Softclix Lancet Device, for quick, easy, and convenient monitoring of blood glucose levels. Medicare and most insurance covers Accu-Chek diabetes self-testing products.