Diabetes can harm one of your most prized assets: your eyesight. But you can take action and lower your odds of getting vision problems, says Elizabeth Seaquist, MD, an endocrinologist at the University of Minnesota.
Lots of studies make it perfectly clear: "The people whose sugars are better controlled always have fewer problems with eye disease," Seaquist says. "People need to work to achieve the level of glucose control that their doctor thinks is important to reduce their risk of eye problems. That’s critically important."
It's also important to manage your blood pressure, she says. High BP, or hypertension, raises the risk of retinopathy, a condition that affects the eyes, she says.
High blood sugar can damage the tiny blood vessels in the retina, a nerve layer at the back of your eye that relays images to your brain. This type of damage is diabetic retinopathy. It causes blood vessels in the retina to weaken and leak fluid. In some people, abnormal blood vessels can grow on the surface of the retina. Left unchecked, diabetic retinopathy can progress to the point of impairing vision.
"Usually the first sign is something the eye doctor sees," Seaquist says. With regular visits, the doctor can catch eye disease before you notice any symptoms.
"You need a dilated eye exam. You need someone who is experienced in looking at the retina," she says. Usually, an ophthalmologist does such exams, but you can get a screening test by a well-qualified optometrist, she says.
Get your eyes screened annually, or as often as your doctor recommends. "The changes that happen in the back of the eye as the result of diabetes are pretty predictable," Seaquist says. "An eye doctor can look at one point in time and get a good sense of what’s going to happen to a person’s eyes over the next year."
If you do get diabetic retinopathy, doctors have many effective treatment options, including lasers that seal leaking blood vessels or that discourage new leaky vessels from forming. This works best before bleeding starts, which is why regular eye doctor visits are crucial. Doctors can also inject medications into the eye to reduce inflammation and shrink troublesome vessels. Or they can surgically remove the blood inside the eye to improve vision.
"The key is getting the treatment at the right point in the progression of the disease to make certain you do not go on to have any vision loss," Seaquist says.
Ask Your Doctor
In your practice, do you see many patients with diabetes?
How does diabetes affect the eyes? What kinds of vision problems might happen?
What blood sugar levels should I aim for to keep my eyes healthy?
When should I have my next eye exam?
What kinds of symptoms should I watch for?
What types of eye problems should I call you about?
Do I show any signs of diabetic retinopathy or other problems?
Do you perform eye surgery?