Diabetes and Eye Health
Diabetes is a chronic disease that changes how the body turns food into energy. The body breaks down food into sugar (glucose) and releases it into the bloodstream. This helps boost blood sugar, which tells the pancreas to release insulin.
Insulin allows blood sugar into cells to be used as energy. However, the body doesn’t make enough insulin with diabetes. This causes blood sugar to stay in the bloodstream, leading to health issues, including eye problems.
More than 37 million people in the U.S. have diabetes.8 This article covers what you need to know about diabetes and how it can affect your eye health.
What is Diabetic Retinopathy?
Diabetic retinopathy is the most common eye disease in people with diabetes. It’s also a leading culprit of blindness in the United States.2
Diabetic retinopathy is a health condition that develops when the blood vessels in the retina change.2 The retina refers to the layer of tissue in the back of the eye that is sensitive to light.
When you look around, the images you see come through your eye’s lens. They are then focused on the retina, which sends them as signals along the optic nerve to your brain. The retina plays an important role in your vision, but diabetic retinopathy can take a toll.
Stages of Diabetic Retinopathy
There are two stages of diabetic retinopathy—nonproliferative and proliferative diabetic retinopathy.
During the nonproliferative stage, the blood vessels in your retina become swollen and leak. You may experience vision issues during this stage if fluid or blood leaks into the central part of the retina (macular edema).2
The second, more advanced stage of diabetic retinopathy is proliferative diabetic retinopathy. New blood vessels grow on your retina that can break and bleed into the vitreous (the natural gel in your eyes). This stage of diabetic retinopathy can lead to severe vision loss.2
Causes & Risk Factors
Diabetic retinopathy happens when there are changes in the blood vessels in your retina. This can happen if you develop diabetes.2
Anyone with a family history of diabetes is at an increased risk of developing the disease. Living a sedentary lifestyle and obesity increases your risk because it’s the most common cause of type 2 diabetes.
If you develop diabetes, you are at further risk of developing diabetic retinopathy. The longer you have diabetes, the more likely you are to develop symptoms like this.2
Other risk factors for developing diabetic retinopathy include:
- High blood pressure
You may not notice any symptoms at first. However, as diabetic retinopathy progresses, you may experience:2
- Blurry vision
- Double vision
- Dark spots in your vision
- Floating spots in your vision
- Blank spots in your vision
- Eye pain
- Eye pressure
- Flashing lights in the eyes
Diabetic retinopathy can also cause neovascular glaucoma. This refers to when blood vessels grow in the drainage structure of the eye. They can block fluid from exiting the eyes.4
It can also result in retinal detachment. This happens when scars form in the back of your eye, pulling your retina away.4
What is a Diabetic Eye Exam?
A diabetic eye exam tests you for diabetic retinopathy. It involves several key steps:
- Health history check
- Family health history check
- Visual acuity test with a common eye chart to measure vision at various distances
- Tonometry to check the pressure inside your eye
- Pupil dilation
- Ophthalmoscopy to examine the retina with a specific magnifying glass
- Fluorescein angiography, which injects organic dye into the bloodstream to show the blood vessels
- Optical coherence tomography to cross-sectional images of the retina
An eye exam usually only takes about 30 minutes. But if your doctor uses drops to dilate your eyes, you may experience blurry vision for about 6 hours after.
Plan to have someone drive you home. You should also bring sunglasses or a hat to shade your eyes, as they may feel extra sensitive.3
Diabetic vs. Regular Eye Exam
A regular eye exam doesn’t look for signs of diabetic retinopathy. It may skip some of the above tests. A regular eye exam will also look for other issues with your eye health.
Who Needs a Diabetic Eye Exam?
If you have diabetes or prediabetes, you should get a diabetic eye exam every year.1,2 Pregnant women should also have one before or within the first trimester of their pregnancy. From there, they should be monitored throughout the pregnancy and the year following birth, depending on the severity.2
How Much Does a Diabetic Eye Exam Cost?
You can be charged anywhere between $50 to $200 for a diabetic eye exam. However, the cost can depend on various factors like:
- First-time or established patient
- Vision insurance coverage
Check with your vision insurance to see whether or not your exams are covered. Medicare Part B covers diabetic eye exams yearly for people with diabetes.6
How to Diagnose Diabetic Retinopathy
Your eye doctor will diagnose diabetic retinopathy with a diabetic eye exam. Only an ophthalmologist (eye specialist) or optometrist (a doctor of optometry) can diagnose you with diabetic retinopathy.
Treatment for Diabetic Retinopathy
There is no cure for diabetic retinopathy, but there are ways to treat it.9 Your treatment will depend on factors like:
- Overall health
- The severity of your condition
Available treatment options include:
1. Laser Surgery
Laser surgery can treat proliferative retinopathy. It shrinks the abnormal blood vessels and closes up any leaky ones.2, 5
A vitrectomy is a medical procedure that removes the vitreous from the center of the eye and replaces it with a saline solution.2
3. Medical Injections
Your doctor may inject medication into your eye to stunt the growth of any abnormal blood vessels. They may also use this medication to treat macular edema.2, 5
Anti-VEGF is one type of medication. It can reduce swelling and improve vision. Corticosteroid medicine is another injection option.4, 7
Can You Prevent Diabetic Retinopathy?
You cannot completely prevent diabetic retinopathy. However, controlling your blood sugar can reduce your risk of developing or slowing its progression if you already have it.2
Many unpleasant symptoms accompany diabetes. You can better avoid or reduce them by being mindful of your blood sugar.2
Diabetes is a common disease, and diabetic retinopathy is a common result. Diabetic retinopathy will ultimately damage your vision and cause partial or total vision loss.
A diabetic eye exam typically diagnoses diabetic retinopathy. The eye exam cost depends on various factors, including your vision insurance.
Although you can’t prevent diabetic retinopathy, you can reduce your risk. Monitor your sugar intake and get annual eye exams.
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