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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.
Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy.
When symptoms do occur, they may include
Talk with your eye doctor if you have any of these symptoms.
You can’t always prevent diabetic retinopathy. However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.
If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:
Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping the progression.
If you have mild or moderate nonproliferative diabetic retinopathy, you might not need treatment right away. However, your eye doctor will closely monitor your eyes to determine when you might need treatment.
Work with your diabetes doctor (endocrinologist) to determine if there are ways to improve your diabetes management. When diabetic retinopathy is mild or moderate, good blood sugar control can usually slow the progression.
If you have proliferative diabetic retinopathy or macular edema, you’ll need prompt treatment. Depending on the specific problems with your retina, options might include:
While treatment can slow or stop the progression of diabetic retinopathy, it’s not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are still possible.
Even after treatment for diabetic retinopathy, you’ll need regular eye exams. At some point, you might need additional treatment.