Diabetes and Aging Eyes: What You Need to Know

If you’re over 50 and you have type 2 diabetes, you face many of the same eye problems as people who don’t have the disease, like cataracts and glaucoma. But there are steps you can take to maintain good eye health and prevent vision loss.

Cataracts and Glaucoma

Cataracts, when the eye’s lens clouds up, are a common cause of vision loss and a normal part of the aging process. Glaucoma, a disease that damages your optic nerve, is a leading cause of blindness for people over 60.

They’re not specific to diabetes, but they can show up earlier if you have it. It all depends on how well you control your blood sugar. And they’re just two more reasons you need to work closely with your doctor to keep the disease under control.

If you already have one of these conditions, talk to your eye doctor about treatment. Early action can prevent blindness from glaucoma. Surgery can remove cataracts.

Diabetic Eye Disease and Diabetic Retinopathy

Diabetic retinopathy is the most common type of diabetic eye disease. The longer you have diabetes, the more likely you are to have some degree of diabetic retinopathy. How bad it will be depends on how well you control your blood sugar.

High blood sugar levels damage blood vessels throughout your body, including the ones in your retina. This thin layer of light-sensitive tissue lines the back of the eye and sends light to your brain. That’s what allows you to see.

There are 2 types:

1. Background or non-proliferative diabetic retinopathy (NPDR): This is the earliest stage. Damaged blood vessels begin to leak into the retina. NPDR can cause changes in the eye including:

  • Macular edema: Blood vessels in the retina leak fluid into the macula and it swells. Located in the center of your retina, it’s what gives you your pinpoint vision. This won’t lead to blindness, but it can cause blurred vision. It can get better once you get your blood sugar and blood pressure under control. If it doesn’t improve, lasers or medications injected directly into your eye may help.
  • Macular ischemia: This loss of blood flow results when small blood vessels in your retina close up. Your vision blurs because the macula no longer gets enough blood to work like it should.

2. Proliferative diabetic retinopathy (PDR): This advanced stage mainly happens when vessels in the retina close up and deprive it of blood. In an attempt to supply blood to the affected area, the retina creates new but abnormal and weak vessels. They can grow into the wrong place and break easily. PDR can cause more severe vision loss than NPDR.

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When to See an Eye Doctor

You may not notice any changes in the early stages. That’s why you need regular eye exams. Even if you don’t have any signs of or risk factors for eye disease, get a screening test at age 40.

If you have diabetes, get a dilated exam as soon as you’re diagnosed. Your doctor will put drops in your eye to widen the pupil. That lets him get a better look at your retina and optic nerve.

Adults with type 2 diabetes should get a dilated eye exam at least once a year. Your eye doctor will let you know if you need to come in more often.

Let him know if you notice sudden vision changes. Blurry vision can result from blood sugar that’s too high or too low.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on February 18, 2018

Sources

SOURCES:

Purnima S. Patel, MD, spokeswoman, American Academy of Ophthalmology; assistant professor, Emory University School of Medicine, Atlanta.

American Academy of Ophthalmology: “What Are Cataracts?;” "What Is Glaucoma?;" “Get Screened at 40;” and “Diabetic Retinopathy Diagnosis.”

American Diabetes Association: “Eye Care.”

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