Diabetes is the leading cause of vision loss for Americans under the age of 74. More than 20 million people have diabetes – and more than 6 million don’t know it. Nearly all those with diabetes will develop some form of diabetic retinopathy, 40% will suffer from glaucoma and 60% will get cataracts.
In honor of November being American Diabetes Month, the California Optometric Association is reminding Americans with diabetes about the importance of scheduling annual, dilated comprehensive eye exams to help detect and even prevent eye and vision disorders that could lead to blindness.
Since the eye is the only place on the body that blood vessels can be seen without having to look through the skin, an eye doctor is able to examine the retina for early warning signs of diabetic eye disease and prescribe a course of treatment to preserve an individual’s sight.
Diabetic Eye and Vision Disorder
People with diabetes are at a significantly higher risk for developing eye diseases including neovascular glaucoma, cataracts, microvascular cranial nerve palsies and diabetic retinopathy.
Diabetes accounts for approximately one-third of cases of neovascular glaucoma. Neovascular glaucoma is a rare type of glaucoma that often results in visual loss. Neovascular glaucoma can occur when new blood vessels grow on the iris, closing off fluid flow in the eye and raising the eye pressure. It can be very difficult to treat, which is why those with diabetes should get their eyes examined on a regular basis.
In addition, people with diabetes are 60 percent more likely to develop cataracts, which is a serious condition that causes the eye’s lens to cloud and interfere with normal vision. Cataracts is a condition that tends to develop at an earlier age in people with diabetes.
Those with diabetes are also more at risk for developing microvascular cranial nerve palsies. Microvascular cranial nerve palsies involve the small bloods vessels that affect the muscles that move the eyes. Symptoms of this condition include not being about to move the eyes in different directions, causing double vision or droopy eyelids. Those with diabetes are at a 7.5x higher rate of suffering from cranial nerve palsies than those without diabetes.
Another condition, called diabetic retinopathy, is a condition occurring in persons with diabetes that causes progressive damage to the retina, the light-sensitive lining at the back of the eye. Diabetes interferes with the body’s ability to use and store sugar and too much sugar in the blood can cause damage to the eyes. Prolonged periods of high blood sugar can lead to the accumulation of fluid in the lens inside the key that controls eye focusing. This increased fluid causes the retinal tissue to swell and can lead to blurred vision.
Symptoms of diabetic retinopathy include:
- Seeing spots in your field of vision
- Cloudy vision
- Empty spots in the center of your vision
- Difficulty seeing at night
Advanced stages of diabetic retinopathy can lead to permanent vision loss. The longer you’ve had diabetes, the more likely you are to have retinopathy, so it’s crucial to get your eyes checked regularly.
How to Prevent Diabetic Eye Disease
Warning signs of diabetic eye disorder are subtle and can often go undetected, which is why it’s important to schedule an eye exam with a doctor of optometry at least once a year. Special factors that put patients more at risk include:
- duration of the diabetes
- poor control of blood sugar
- lack of exercise
- family history of diabetes
In addition to having a yearly, comprehensive eye exam, the California Optometric Association offers the following tips to help prevent or slow the development of diabetic eye disease:
- Take prescribed medication as directed
- Keep glycohemoglobin test results (“A1c” or average blood sugar level) consistently under 7 percent
- Stick to a healthy diet that includes Omega 3s, fresh fruits and vegetables
- Exercise regularly
- Control high blood pressure
- Avoid alcohol and smoking
Early detection and maintenance is key to controlling the progress of diabetic eye diseases.
Melissa Barnett, OD, FAAO is a Principal Optometrist at the UC Davis Medical Center in Sacramento. She specializes in anterior segment disease and specialty contact lenses. Dr. Barnett lectures and publishes extensively on topics including dry eye, anterior segment disease, contact lenses, corneal collagen cross-linking and creating a healthy balance between work and home life for women in optometry. She serves on the Board of Women of Vision (WOV), Gas Permeable Lens Institute (GPLI) and The Scleral Lens Education Society (SLS). Dr. Barnett is a spokesperson for the California Optometric Association and has appeared on several television shows. In her spare time she enjoys cooking, yoga and spending time with her husband, Todd Erickson, also an optometrist, and two sons, Alex (8) and Drew (6).