Diabetes mellitus is categorized as Type I (formerly called insulin-dependent) and Type II (non-insulin dependent). Serious eye problems can arise from diabetes that is not well controlled, and sometimes even when blood sugar levels are well controlled. For this reason, yearly eye examinations including dilated eye health evaluations are recommended.
If blood sugar levels change drastically, temporary changes in the size and shape of the lens within the eye can cause rapid and large prescription changes. Any noticeable visual sharpness changes with current eyeglasses or contact lenses, especially blurriness when viewing far distances, should result in an immediate eye and vision examination. The vision prescription changes are reversible when blood sugar levels return to normal levels. Your eye doctor should be contacted immediately if you notice this type of sudden vision change.
The primary cause of permanent eye damage from diabetes is the poor condition of the small blood vessels inside of the eye. As blood sugar levels become elevated and stay high for long periods, the blood vessel walls become leaky. When blood cells and plasma leak from the blood vessels on the retina, the light sensitive membrane on the inner wall of the eye, the fluid can interfere with visual sharpness and can begin a process of damage to the normal retina tissue. A lack of oxygen to the increasingly swollen retinal tissue can cause more severe problems that include the growth of new, poorly formed blood vessels on the retina surface. These new vessels are quite fragile and frequently break causing catastrophic effects on vision. They may even grow on the surface of the iris, the colored tissue at the front of the eye,which could cause a unique type of glaucoma.
The eye doctor’s role in your health care for diabetes is to evaluate your eyes to determine if any diabetic changes are present and whether notable damage can be simply observed through repeat exams or referred to a retinal specialist for examination and possible treatment. If surgical treatment is required, it is often a type of laser surgery to the retina and the eye doctor can make the appropriate referral to a retinal specialist who has expertise in taking care of diabetic patients. The eye doctor will make an effort to inform your primary care provider of any examination that is completed and will convey the status of the eyes to help guide the medical management that you are given.