Can Diabetes Affect Your Eyes?

Yes. You should plan to make regular eye doctor visits if you have diabetes. High blood sugar can lead to problems like blurry vision, cataracts, glaucoma, and retinopathy. In fact, diabetes is the primary cause of blindness in adults ages 20 to 74.

Blurry Vision

Don't buy new glasses as soon as you notice that things look blurry. It could just be a small problem caused by high blood sugar. Your lens could swell, which changes your ability to see.

To correct it, you need to get your blood sugar back into the target range (70-130 milligrams per deciliter, or mg/dL, before meals, and less than 180 mg/dL 1 to 2 hours after a meal). It may take as long as 3 months for your vision to fully get back to normal.

Do tell your eye doctor. She can let you know if this is a symptom of a more serious problem.

Cataracts

The lens allows your eye to see and focus on an image, just like a camera. Cataracts cloud your normally clear lens with debris. Anyone can get them, but people with diabetes tend to get them earlier, and they get worse faster.

When part of your lens is cloudy, your eye can’t focus like it should. You won't see as well. Symptoms include blurred vision and glare.

You’ll need surgery to remove a cataract. The doctor replaces the cloudy lens with an artificial one.

Glaucoma

Pressure builds up inside your eye when fluid can’t drain like it should. This can damage nerves and blood vessels, and cause changes in vision.

Medications can treat open-angle glaucoma, the most common form. They lower eye pressure, speed up drainage, and reduce the amount of liquid your eye makes. (Your doctor will call this aqueous humor.)

This type of glaucoma may not cause any symptoms until it’s further along and you have major vision loss. Your doctor can catch it earlier, during an annual exam.

With less common forms of the disease, you might notice:

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Treatment can include medicine and special eye drops. Surgery and laser treatments can help with drainage.

If you have diabetes, you’re also more likely to get a rare condition called neovascular glaucoma. This makes new blood vessels grow on the iris, the colored part of your eye. They block the normal flow of fluid and raise eye pressure.

It's difficult to treat. Your doctor might try laser surgery to cut back on the vessels. Or he could use implants to help drain the fluid.

Diabetic Retinopathy

The retina is a group of cells on the back of your eye that take in light. They turn it into images that the optic nerve sends to your brain.

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Damage to small blood vessels in your retina causes diabetic retinopathy. It's related to high blood sugar levels. If you don’t find and treat it early, you could go blind. The longer you have diabetes, the more likely you are to get it. If you keep your blood sugar under control, you lower your chances.

People with type 1 diabetesrarely develop the condition before puberty. In adults, it's rare to see unless you've had type 1 diabetes for at least 5 years. If you keep tight control of your blood sugar with either an insulin pump or multiple daily insulin injections, you’re far less likely to get this condition.

If you have type 2 diabetes,you may have signs of eye problems when you’re diagnosed. Control your blood sugar, blood pressure, and cholesterol to slow or prevent the disease. If you smoke, try to quit. It’ll improve your eyes and your overall health.

There are other types of this condition:

Background retinopathy. Your blood vessels are damaged, but you can still see OK. It can get worse if you don't manage your diabetes well.

Maculopathy. This is damage to the macula, a critical area of your retina. It can greatly affect your vision.

Proliferative retinopathy. It happens when cells at the back of your eye don’t get enough oxygen and new blood vessels start to grow. They’re fragile, so they can bleed and lead to a clot. This can cause scars and pull your retina away from the back of your eye. If it gets detached, you could have vision loss that can't be fixed. Sometimes this condition can be treated. Surgery is an option, so is a laser procedure that burns away the blood vessels. It can prevent blindness in up to half the people with early retinopathy.

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The Need for Eye Exams

A full yearly checkup can help find problems early, when they're easier to treat. That could save your vision.

If you might get pregnant in the near future, get an eye exam to avoid possible problems. Keep them up while you’re pregnant, too.

When to Call the Doctor

These symptoms can signal an emergency:

  • Black spots in your vision
  • Flashes of light
  • "Holes" in your vision
  • Blurred vision
WebMD Medical Reference Reviewed by Michael Dansinger, MD on January 09, 2016

Sources

SOURCES: 

American Diabetes Association: "Eye Disease"  and "Mental Health Problem Linked to Diabetes." 

Centers for Disease Control and Prevention: "Take Charge of Your Diabetes." 

Colucciello, M. Arch Ophthalmol,  2005; 123:1273.

Hernandez, C. Diabetes Care, 2006; 29:2028.

The Glaucoma Research Foundation: "Diabetes and Your Eyesight."

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