Diabetes and Your Eyesight

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Diabetes is a health condition that affects how your body turns food into energy. During digestion the stomach turns carbohydrates (sugars and starches) into glucose. The stomach and small intestines absorb the glucose and release it into the bloodstream where it is used for energy or stored as fat in our bodies for later use.

A healthy body keeps the level of glucose in the blood at a constant level. Beta cells in the pancreas monitor the blood sugar level every few seconds and if they detect a rise the beta cells release insulin. The insulin binds to receptors on the surface of cells and that allows the cells to take in the circulating glucose. In people with diabetes this cellular response to circulating glucose is impaired or their beta cells stop producing insulin and they develop hyperglycemia (high blood sugar).

Having high blood sugar for long periods of time can damage the blood vessels and that in turn affects every organ that depends on those blood vessels for vital nutrients. Diabetes can cause heart disease, stroke, kidney disease, nerve damage, and damage to the structures of the eye.  

Diabetic Retinopathy

Diabetic retinopathy is the eye disease caused by diabetes.

Over time, uncontrolled blood sugar can cause the blood vessels in the retina to hemorrhage (leak) and this bleeding distorts vision. If it continues unchecked then new blood vessels may grow on the retinal surface and damage the cells on the retina. This cycle can lead to blindness, but the condition can often be successfully treated if caught early. Eye injections of an anti-VEGF (vascular endothelial growth factor) can block the formation of new blood vessels in the eye.

Signs and Symptoms of Diabetic Retinopathy

The very early stages often have no symptoms which is why it is important to have yearly eye exams if you are diabetic.

As diabetic retinopathy progresses the following symptoms may occur:

  • Blurred or fluctuating vision
  • Floaters (dark spots or strings) that appear in your field of view
  • Blind spots
  • Color vision loss

If the diabetic retinopathy is allowed to continue unchecked it can lead to a retinal detachment.

Retinal Detachment

Scar tissues that were formed from leaking blood vessels can cause the retina to pull away from its underlying tissue. A retinal detachment can be a medical emergency and must be treated immediately to prevent permanent vision loss. A sudden onset of floaters or flashes in the vision can be warning signs of an impending retinal detachment. So called diabetic retinal detachments, however, develop more slowly.

Diabetes and Diabetic Macular Edema (DME)

The damaged blood vessels can also leak into the macula (the part of the eye that creates sharp, central vision). This can cause the macula to swell leading to blurred vision and vision loss. DME is also treatable with injections of anti-VEGF.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss caused by diabetes is with early detection and treatment. Having regular eye exams is the best way to detect any diabetic eye disease in its very early stage. 

Gregory Scimeca, M.D.
Ophthalmologist and Medical Director
The Eye Professionals

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