Why Eye Exams Can't Wait When You Have Diabetes

This article is for people who have diabetes and their care partners, or anyone who wants to learn more about how diabetes can affect eyesight. The goal of this patient education activity is to help people understand why eye exams are important when you have diabetes.

You will learn about:

• How diabetes can damage your eyesight

• What diabetic retinopathy and diabetic macular edema (DME) are and their symptoms

• Why eye exams are so important

• Treating diabetic retinopathy and DME

• Questions to ask your doctor

Diabetic eye disease is a group of eye conditions that includes diabetic retinopathy, diabetic macular edema (DME), cataracts, and glaucoma. All of these can cause severe vision (eyesight) loss and even blindness.

Diabetic retinopathy is the most common diabetic eye disease and the leading cause of vision loss in people who have diabetes. DME often happens along with diabetic retinopathy -- about half of all people who have diabetic retinopathy will get DME.

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

These vessels can then weaken and bleed, leaking fluid into your retina and distorting your vision. This fluid can build up and cause swelling (edema) in your macula, the part of your retina where light gets focused to give you sharp vision.

This results in DME, a serious complication of diabetic retinopathy that causes additional vision changes. DME is the most common cause of blindness in people who have diabetic retinopathy.

Diabetic retinopathy happens when your blood sugar (glucose) levels are too high for too long. Over time, high blood sugar can harm blood vessels throughout your body. This includes blocking and damaging the small blood vessels in your retina.

To work around these damaged vessels, your eye may try to grow new ones. But these new blood vessels won't develop normally. As more vessels become blocked and more new abnormal vessels grow, they can scar your retina and cause even more vision problems.

Diabetic retinopathy and DME often have no noticeable symptoms early on. There is no pain and your vision may change so slowly over time that you don't even realize it's happening until your condition becomes severe.

As diabetic retinopathy or DME gets worse, symptoms and changes in your eyesight can include:

• Holes, black spots, or dark/empty areas

• Spots or dark strings called "floaters" that may come and go

• Blurriness, haziness, or waviness

• Not being able to see colors, or colors that look washed out or faded

• Central vision (fine, sharp, straight-ahead vision) loss when you read or drive

• Fluctuating vision (gets worse, improves, then gets worse again)

• Eye pain

Contact your doctor right away if your vision changes suddenly or if you have any symptoms.

Getting eye exams so your doctor can find and treat problems early can help protect your eyesight.

Many people with diabetic retinopathy or DME may not even know they have it at first. But severe and permanent eye damage can happen before you notice any symptoms or vision changes.

Only your eye doctor can recognize (diagnose) diabetic retinopathy or DME for sure. So getting eye exams -- even if your eyesight seems fine -- is important when you have diabetes.

Getting a full, dilated eye exam every year -- or more frequently if your doctor recommends it -- can help your doctor find and treat diabetic retinopathy or DME early. The earlier eye problems are found and treated, the better.

Diabetic retinopathy and DME can cause permanent vision loss, and even blindness, if not treated properly. But getting eye exams to catch and treat them early -- and sticking to treatment -- means you may be able to help slow or stop vision damage.

Treatments your doctor may recommend can include:

• Vascular endothelial growth factor (VEGF) inhibitor, or anti-VEGF, medicines to help stop new abnormal blood vessels from growing and fluid leaks

• Steroid medicines to help with inflammation with DME

• Laser surgery to seal off leaking vessels and stop or shrink new abnormal vessels

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

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

In addition to getting eye exams as recommended by your doctor, one of the best ways to help prevent or delay vision loss is by carefully managing your diabetes.

Ways to do this include:

• Keeping your blood sugar as close to a healthy level as possible

• Managing your blood pressure and cholesterol

• Eating a healthy diet and limiting alcohol

• Staying physically active and maintaining a healthy weight

• Not smoking

• Taking all medicines as directed and keeping all medical appointments

Talk to you doctor about diabetes and your eyesight. Getting eye exams and managing your diabetes can help protect you against vision loss.

Questions to ask your doctor can include:

• Am I at risk for diabetic retinopathy and DME?

• What can I do to help protect my eyesight?

• How often should I have an eye exam?

• How can I help manage my diabetes?

• Are there any lifestyle changes I should make?

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

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

Congratulations!

You have successfully completed the program: Why Eye Exams Can't Wait When You Have Diabetes.

View Additional Materials on this topic that you may find useful

Diabetes and Vision Loss

Diabetes and You: Healthy Eyes Matter

Diabetic Eye Disease

Diabetic Retinopathy

Take Charge of Your Diabetes: Healthy Eyes