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Question: How does diabetes affect the eyes?

Answer: Over time, diabetes causes damage to organs in the body. The eyes are organs at great risk of damage from this disease condition. Long-standing diabetes can lead to an eye disease called diabetic retinopathy. Anyone with any kind of diabetes can get diabetic retinopathy — including people with type 1, type 2, and gestational (pregnancy related) diabetes. The longer a person has diabetes, the greater his/her risk of developing diabetic retinopathy. In fact, more than half of people with diabetes will develop diabetic retinopathy. Women with diabetes who become pregnant — or women who develop gestational diabetes — are at high risk for getting diabetic retinopathy.

Diabetes damages blood vessels all over the body. In the eyes, diabetes directly affects the retina — the light-sensitive layer at the back of the eyes. The retina has a network of tiny blood vessels that supply blood to the eye. When a person has diabetes, the sugar in the blood blocks the tiny blood vessels that go to your retina. This causes the blood vessels to swell, leak fluid or bleed. When the retina gets swollen, vision gets blurry. When the vessels leak blood into the eye, vision gets very murky. Also, blood supply to the retina is decreased. To compensate for these blocked blood vessels, the eyes then grow new blood vessels that don’t work well. These new blood vessels can leak or bleed easily, perpetuating the cycle of the disease.

Diabetic retinopathy does not happen immediately. It happens after years of having the disease. The longer a person has diabetes, the higher their likelihood of developing diabetic retinopathy. The unfortunate thing is that there are no symptoms early in the disease, so diabetic eye disease can go undetected for a long time. That is why it is important to have a comprehensive eye examination once a year. Further on in the course of the disease, diabetics may experience blurred vision, floaters (tiny black dots or strings floating around in their eyes), or blocked vision from the bleeding.

The good news is that you can lower your risk of developing diabetic retinopathy by controlling your diabetes. Physical activity, a healthy diet, and sticking to your medication routine can also help you prevent or delay vision loss. Controlling your blood sugar is key to reducing the impact of diabetes on the eyes.

If you have diabetes, it’s very important to get regular eye exams. If you do develop diabetic retinopathy, early treatment can stop the damage and prevent blindness, as without treatment, scars can form in the back of the eye. Eye doctors can check for diabetic retinopathy as part of a dilated eye exam. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for diabetic retinopathy and other eye problems. In the early stages of diabetic retinopathy, your eye doctor will probably just keep track of how your eyes are doing. Some people with diabetic retinopathy may need a comprehensive dilated eye exam as often as every two to four months. In later stages, it’s important to start treatment right away, especially if you have changes in your vision. Treatment options for diabetic retinopathy include laser procedures, injections into the eyes and even surgery. While these treatment options won’t undo any damage to your vision, treatment can stop your vision from getting worse. It’s also important to take steps to control your diabetes, blood pressure, and cholesterol.

In conclusion, diabetes can have detrimental effects on your eyes. It is imperative that all diabetic patients try their very best to control their blood sugar levels, as treatment can be quite expensive and can prove mentally and emotionally draining.

Novia Jerry Stewart, MSc, RPh, is a pharmacist who specialises in diabetes care. She may be contacted for diabetes care coaching sessions at diabetescarepharmacist@gmail.com.