Diabetic Eye Disease: How Diabetes Affects Your Eyes

Diabetic eye disease is the name for the eye problems diabetes can cause: diabetic retinopathy, macular edema, cataracts and glaucoma. Many of our patients in The Villages live with diabetes. Most of them keep good vision for life, and a yearly eye exam is a big part of how.

High blood sugar slowly damages small blood vessels all over the body. The retina, at the back of the eye, is packed with them.

That is why your eyes are often where diabetes shows up first. The CDC’s diabetes pages explain the condition itself.

The 4 types of diabetic eye disease

Diabetic retinopathy. Weak blood vessels in the retina leak or bleed. In the early stage (non-proliferative), vessels swell and seep fluid.

In the later stage (proliferative), new fragile vessels grow and can bleed into the eye. The National Eye Institute calls it the most common cause of vision loss in people with diabetes.

Diabetic macular edema. Fluid collects in the macula, the small center of the retina you use to read and see faces.

Straight lines can look wavy. It can happen at any stage of retinopathy.

Cataracts. Everyone’s lens clouds with age.

With diabetes, it tends to happen sooner. Our page on cataracts for adults covers the signs.

Glaucoma. Diabetes raises the risk of glaucoma, which harms the optic nerve. One rare type, neovascular glaucoma, grows directly out of advanced retinopathy.

Diabetes has a short-term effect too. When your blood sugar swings, the lens can swell and your vision blurs for a while. It usually settles when your sugar does.

Signs to watch for

Early diabetic eye disease often has no symptoms at all. Later, you might notice:

• floaters or dark spots
• blurry or wavy central vision
• colors that look faded
• trouble seeing at night
• vision that changes from day to day

Any sudden change, like a shower of new floaters or a dark curtain over part of your vision, needs a same-day call to an eye doctor.

6 ways to protect your sight

1. Keep your blood sugar steady. Your primary care doctor or endocrinologist is your partner here.
2. Come in once a year. A yearly dilated exam catches changes before you notice them. See our diabetic eye exam page.
3. Watch blood pressure and cholesterol. Both make retinopathy worse.
4. Don’t smoke. It damages the same small vessels diabetes does.
5. Wear UV-blocking sunglasses. Florida sun is strong, and UV adds to cataract risk.
6. Stay active and eat well. Leafy greens, colorful vegetables and fish are good for your whole body, eyes included.

What happens at a diabetic eye exam

Dr. James Russell checks your vision and eye pressure, then widens your pupils with drops so he can see the whole retina. Our digital retinal scan saves a picture of it.

Next year, we compare the two and look for anything new. Our page on dilated eye exams explains the drops.

If we find retinopathy or swelling that needs treatment, we refer you to a retina specialist. Treatments they use include laser, anti-VEGF injections into the eye and, in advanced cases, surgery called vitrectomy.

Questions patients ask us

How often should I get my eyes checked with diabetes?

Once a year for most people. If we see changes, we may ask you to come back sooner.

Can the damage be undone?

Some of it can be treated, and treatment works best when it starts early. That’s the reason for yearly exams, even when your eyes feel fine.

Will diabetes make me go blind?

Most people with diabetes never lose serious vision. Good sugar control and regular exams lower the risk a great deal.

Can I still wear contact lenses?

Many people with diabetes wear contacts without trouble. We check your eyes first and tell you what fits. Compare contact lenses vs eyeglasses.

Your next step

If you have diabetes and it’s been more than a year, now is a good time. Book your eye exam or call our Pinellas Plaza office at (352) 399-5412.