Diabetes and eye disease
Diabetes can harm the eyes. It can damage the small blood vessels in the retina, the back part of your eye. This condition is called diabetic retinopathy.
Diabetes also increases the chance of having glaucoma, cataracts, and other eye problems.
Retinopathy - diabetic; Photocoagulation - retina; Diabetic retinopathy
Diabetic retinopathy is caused by damage from diabetes to blood vessels of the retina. The retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals, which are sent to the brain.
There are two stages of diabetic retinopathy:
The chance of getting retinopathy and having a more severe form is higher when:
Other eye problems that can develop in persons with diabetes include:
Most often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.
Symptoms of diabetic retinopathy include:
Many people with early diabetic retinopathy have no symptoms before bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams.
Exams and Tests
Your eye doctor (ophthalmologist) will examine your eyes. You may first be asked to read an eye chart. Then you will receive eyedrops to widen the pupils of your eyes. Tests you may have involve:
Measuring the fluid pressure inside your eyes (tonometry)
Checking the structures inside your eyes (slit lamp exam)
Checking and photographing your retinas (fluorescein angiography)
If you have the early stage of diabetic retinopathy (nonproliferative), the eye doctor may see:
If you have advanced retinopathy (proliferative), the eye doctor may see:
Persons with early diabetic retinopathy may not need treatment. But they should be closely followed by an eye doctor who is trained to treat diabetic eye diseases.
Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.
Eye surgery is the main treatment for diabetic retinopathy.
Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called photocoagulation. It is used to keep vessels from leaking or to shrink abnormal vessels.
Surgery called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.
Medicines that are injected into the eyeball may help prevent abnormal blood vessels from growing.
Follow your eye doctor's advice on how to protect your vision. Have eye exams as often as recommended.
American Diabetes Association | www.diabetes.org
National Diabetes Information Clearinghouse | www.diabetes.niddk.nih.gov
Prevent Blindness America | www.preventblindness.org
Managing your diabetes may help slow diabetic retinopathy and other eye problems. Control your blood sugar (glucose) level by:
Treatments can reduce vision loss. They do not cure diabetic retinopathy or reverse the changes that have already occurred.
Diabetic eye disease can lead to reduced vision and blindness.
When to Contact a Medical Professional
Call for an appointment with an eye doctor (ophthalmologist) if you have diabetes and you have not seen an ophthalmologist in the past year.
Call your doctor if any of the following symptoms are new or are becoming worse:
Tight control of blood sugar, blood pressure, and cholesterol is very important for preventing diabetic retinopathy.
Do not smoke. If you need help quitting, ask your doctor or nurse.
American Diabetes Association. Standards of medical care in diabetes -- 2013. Diabetes Care. 2013;36 Suppl 1:S11-S66.
Brownlee M, Aiello LP, Cooper ME, et al. Complications of diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa.: Elsevier Saunders; 2011: chap 33.
Rosenblatt BJ, Benson WE. Diabetic retinopathy. In: Yanoff M, Duker JS, Augsburger JJ, eds. Ophthalmology. 3rd ed. Philadelphia, Pa.: Elsevier Mosby; 2008:chap 6.19.
Review Date: 5/28/2013
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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