Protecting Your Eyesight When You Have Diabetes

This article is for people who have diabetes, or their care partners, or anyone who wants to learn more about protecting eyesight for people with diabetes. The goal of this patient education activity is to help patients and caregivers engage in shared decision-making with their doctor about screening for diabetic retinopathy, including when to get eye exams.

You will learn about:

• What diabetic retinopathy is and how diabetes causes it

• Symptoms of diabetic retinopathy

• Ways you can help protect your eyesight if you have diabetes

• Diabetic retinopathy treatment

• Questions to ask your doctor

Diabetic retinopathy is the most common type of diabetic eye disease, a group of eye conditions that can happen in people who have diabetes.

Diabetic retinopathy can cause permanent vision (eyesight) loss, and even blindness, if not treated. It is the most common cause of vision loss in people with diabetes, and the leading cause of blindness in people 20 to 60 years old. But if diabetic retinopathy is found and treated early, blindness can be prevented.

Anyone with type 1 or type 2 diabetes can get diabetic retinopathy.

Your risk of developing it mainly depends on:

• How long you've had diabetes -- the longer, the greater your chance of diabetic retinopathy

• How often your blood glucose (sugar) changes and how controlled your levels are

Other factors that can increase your risk include:

• High blood pressure

• High cholesterol

• Being pregnant

• Smoking

Diabetic retinopathy happens when the small blood vessels in your retina (tissue lining the back of your eye that changes light into images) get damaged.

Over time, high blood sugar blocks these vessels. As a result, they bulge and weaken, and blood and fluid leak into the retina affecting your eyesight.

To work around this, your eye may try to grow new blood vessels, but they won't develop normally. As more vessels get blocked and more new abnormal vessels grow, they cause scarring on your retina and damage your eyesight further.

Diabetic retinopathy usually happens in both eyes.

Diabetic retinopathy usually has no symptoms, especially early on. Severe and permanent damage to your eyes, and even blindness, can happen before you notice any changes or problems with your eyesight. This is why getting eye exams and having your eyesight checked to find or stop diabetic retinopathy early are so important.

As diabetic retinopathy gets worse, symptoms and changes in your eyesight that may happen include:

• Spots or dark strings called "floaters"

• Holes or dark/empty areas

• Blurriness or haziness

• Being unable to see colors

• Vision (eyesight) that fluctuates (gets worse, improves, gets worse again)

• Vision loss, including when you read or drive

• Eye pain

Contact your doctor right away if your eyesight changes suddenly or if you start having any symptoms.

One of the best ways to help prevent or delay vision loss is with careful diabetes management.

Ways to manage your diabetes and help keep your eyes healthy include:

• Keep good control of your blood sugar

• Manage your blood pressure and cholesterol levels

• Take medicines as directed

• Eat a healthy diet and limit alcohol

• Stay physically active and maintain a healthy weight

• Quit smoking

• Visit your doctor regularly and get your hemoglobin A1C checked

If you have diabetes, getting a full, dilated eye exam every year is the only way to know for sure if you have diabetic retinopathy. Your doctor may also recommend an exam more frequently.

Because diabetic retinopathy often has no symptoms and goes unnoticed until vision loss happens, you should get an eye exam even if your eyesight seems fine. This can help your doctor find and treat eye problems early.

If you're pregnant and have diabetes, get a complete eye exam in your first trimester. Your doctor may also recommend additional eye exams during your pregnancy.

For dilation, your doctor will put drops in your eyes to widen (dilate) your pupils so they can see the back of your eye, including the retina. This way, they can examine a larger area with a special magnifying lens. Your eyesight may be blurry for a few hours after a dilated eye exam.

Your doctor will also test your eyesight and may recommend other tests, such as measuring the pressure in your eyes.

Finding and treating diabetic retinopathy early can help slow its progress, and may even reverse some types of vision loss.

With mild diabetic retinopathy, you may not need treatment right away, but your doctor will follow up with you closely.

If your condition is more severe, your doctor may recommend:

• Medicines called vascular endothelial growth factor (VEGF) inhibitors, or anti-VEGFs, to help stop new abnormal blood vessels from growing and fluid leaks

• Laser treatment to seal off leaks and shrink or stop new abnormal vessels

• Vitrectomy, surgery to remove blood, fluid, and scar tissue from the eye

Getting eye exams and having your eyesight checked, timely treatment, and managing your diabetes can all help protect against vision loss.

Questions to ask your doctor about your eyesight and diabetic retinopathy can include:

• Am I at risk for diabetic retinopathy?

• What can I do to help protect my eyesight?

• How often should I have an eye exam?

• How can I help control my diabetes?

• What treatments are available and what are their side effects?

• What type of diet and exercise is best for me?

• Are there lifestyle changes I should make?

Congratulations!

You have successfully completed the program: Protecting Your Eyesight When You Have Diabetes

View Additional Materials

View Additional Materials on this topic that you may find useful:

Watch Out for Diabetic Retinopathy

Diabetic Retinopathy

Diabetic Eye Disease