Diabetic eye disease: What you should know

By Dr. Steven A. Nielsen

As we leave the mildness of early autumn behind and prepare for the approaching colder months, it is important not only to take preventative measure to protect our bodies against illness (getting flu shots, taking a multi-vitamin supplement and dressing for the weather), but also to take care of our eyes.  This is especially critical for those diagnosed with diabetes.

According to the Center for Disease Control (CDC), between 12,000 and 24,000 new cases of blindness related to diabetic retinopathy occur in the United States each year. It is the number one cause of blindness in the United States.

Diabetes retinopathy occurs in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneursyms, which are weakened areas in the walls of tiny blood vessels in the retina. Ruptures result, which lead to hampered blood flow, as well as swelling and leakage that causes scarring, blind spots and ultimately, blindness. Often abnormally high blood sugar levels cause these microaneursyms.

You may first notice diabetic retinopathy (DR) or other eye problems related to diabetes when you have symptoms such as:

•Fluctuating vision;

•Eye floaters and spots;

•Development of a scotoma or shadow in your field of view;

•Blurry and/or distorted vision;

•Corneal abnormalities such as slow healing of wounds due to corneal abrasions;

•Double vision;

•Eye pain;

•Near vision problems unrelated to presbyopia; and

•Cataracts.

The best way to treat diabetic retinopathy is to control your blood sugar.

Diabetic retinopathy is not the only eye disease associated with diabetes. Diabetics are also more likely to contract bacterial infections, such as pink eye and/or eyelid styes. Diabetes affects the autoimmune system, lowering resistance to infection. Some of the best ways to avoid contracting these infections include keeping blood sugar levels low, practicing good hygiene by washing hands frequently and avoiding rubbing and touching the eyes and the skin around the eyes.

Fluctuating blood sugars are known to cause fluctuating vision. There is a direct correlation between the change in blood sugar levels and the ability of the crystalline lens in the eye to maintain sharp focus. Blood sugar levels must be under control at all times in order to be prescribed glasses or contacts. Because of the nature of diabetes, changes in vision may occur more than once over a period of months. However, glasses or contacts cannot be prescribed unless glucose levels are stable. A good rule of thumb for knowing when to get new glasses is to monitor blood sugar levels for three months. If they are relatively stable, your glasses prescription will be accurate, especially if your glucose reading stays below 7 percent.

Being able to monitor any vision changes, as well as any abnormalities in vision is essential in keeping diabetic eyes health, thus making it essential for yearly, and in some cases, bi-annual, eye exams.