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Diabetes and Vision Loss

Diabetes can damage your eyes over time and can cause vision loss and even blindness. Managing your diabetes and getting regular eye exams can help prevent vision problems and stop them from getting worse.


DIABETIC RETINOPATHY

This common eye disease is the leading cause of blindness in adults. Diabetic retinopathy is caused when high blood sugar damages blood vessels in the retina, a light-sensitive layer of cells in the back of the eye. Damaged blood vessels can swell and leak, causing blurry vision or stopping blood flow. Sometimes new blood vessels grow, but they aren’t normal and can cause further vision problems. Diabetic retinopathy usually affects both eyes.


Anyone with type 1, type 2, or gestational diabetes can develop diabetic retinopathy. The longer you have diabetes, the more likely you are to develop it.


STAGES OF DIABETIC RETINOPATHY

Diabetic retinopathy has 2 main stages:


Early stage (non-proliferative): Blood vessel walls in the retina weaken and bulge, forming tiny pouches. These pouches can leak blood and other fluid, which can cause a part of the retina called the macula to swell (macular edema) and distort your vision. Macular edema is the most common cause of blindness in people with diabetic retinopathy. About half of people with diabetic retinopathy will develop macular edema.


Advanced stage (proliferative): In this stage, the retina begins to grow new blood vessels. These new vessels are fragile and often bleed into the vitreous (the clear gel between the lens and retina). With minor bleeding, you may see a few dark spots that float in your vision. If there’s a lot of bleeding, your vision may be completely blocked.


You may not notice symptoms in the early stage. That’s why it’s very important to get a dilated eye exam at least once a year to catch any problems early when treatment is most effective.


Symptoms in the advanced stage can include:

  • Blurry vision

  • Spots or dark shapes in your vision (floaters)

  • Trouble seeing colors

  • Dark or empty areas in your vision

  • Vision loss


DIAGNOSING DIABETIC RETINOPATHY

During your eye exam, your eye doctor will check how well you see the details of letters or symbols from a distance. Your doctor will also look at the retina and inside of your eyes and may use a dye to reveal leaky blood vessels. If it turns out you have diabetic retinopathy, your eye doctor may want to check your vision more often than once a year.

You should be checked for diabetic retinopathy immediately if you’re diagnosed with type 2 diabetes. If you have type 1 diabetes, you should be checked within 5 years of your diagnosis and then regularly thereafter, typically every year. The sooner you’re treated for diabetic retinopathy, the better that treatment will work.


Call your eye doctor if you notice changes in your vision, especially if they happen suddenly. Changes may include:

  • Blurring

  • Spots

  • Flashes

  • Blind spots

  • Distortion

  • Difficulty reading or doing detail work


TREATING DIABETIC RETINOPATHY

Treating diabetic retinopathy can repair damage to the eyes and even prevent blindness in most people. Treatment can start before your sight is affected, which helps prevent vision loss. Options include:

  • Laser therapy (also called laser photocoagulation). This creates a barrier of scar tissue that slows the growth of new blood vessels.

  • Medicines called VEGF inhibitors, which can slow down or reverse diabetic retinopathy.

  • Removing all or part of the vitreous (vitrectomy).

  • Reattachment of the retina (for retinal detachment, a complication of diabetic retinopathy).

  • Injection of medicines called corticosteroids.


PREVENTING DIABETIC RETINOPATHY

You can protect your vision and lower your chance for vision loss with these steps:

  • Get a dilated eye exam at least once a year so your eye doctor can spot any problems early when they’re most treatable.

  • Keep your blood sugar levels in your target range as much as possible. Over time, high blood sugar not only damages blood vessels in your eyes, it can also affect the shape of your lenses and make your vision blurry.

  • Keep your blood pressure and cholesterol levels in your target range to lower your risk for eye diseases and vision loss.

  • Quit smoking. Quitting lowers your risk for diabetes-related eye diseases and improves your health in many other ways too.

  • Get active. Physical activity protects your eyes and helps you manage diabetes.


Eye problems are common in people with diabetes, but treatments can be very effective. Only your eye doctor can diagnose eye diseases, so make sure to get a dilated eye exam at least once a year. The earlier eye problems are found and treated, the better for your eyesight.




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