Diabetes affects more than blood sugar. Over time it can quietly damage the eyes, often before you notice any change in how you see.
The good news: a yearly eye exam can catch problems early, when there are more ways to protect your vision. This guide explains what to watch for and what to expect, using information from the National Eye Institute (NEI) and the American Academy of Ophthalmology (AAO).
What is diabetic retinopathy?
Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. High blood sugar damages the tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye. Those vessels can swell, leak or close off, and the eye may grow fragile new vessels that bleed easily. The NEI calls it the most common cause of vision loss for people with diabetes.
Diabetes can also raise your risk of other eye problems. According to the NEI:
- Diabetic macular edema (DME). Over time, about 1 in 15 people with diabetes develop DME, when fluid leaks into the macula and blurs central vision.
- Cataracts. Having diabetes makes you 2 to 5 times more likely to develop cataracts, often at a younger age. Learn more on our cataract surgery page.
- Open-angle glaucoma. Diabetes nearly doubles your risk. Read about our glaucoma treatment.
"Diabetic retinopathy may not have any symptoms at first, but finding it early can help you take steps to protect your vision."
NATIONAL EYE INSTITUTE
Who is at risk?
Anyone with any type of diabetes can get diabetic retinopathy, including type 1, type 2 and gestational diabetes. The NEI says your risk goes up the longer you have diabetes, and over time more than half of people with diabetes will develop it. Controlling your diabetes lowers that risk.
Pregnancy and diabetes
Women with diabetes who become pregnant, or who develop gestational diabetes, are at high risk. The NEI advises a comprehensive dilated eye exam as soon as possible, and asking your doctor whether you need more exams during pregnancy.
Symptoms to know
Early stages usually have no symptoms. As the disease gets worse, the AAO lists signs such as more floaters, blurry vision, vision that changes from blurry to clear, blank or dark areas in your vision, poor night vision, and colors that look faded or washed out. Symptoms can affect both eyes.
New floaters? Don't wait
If you have diabetes and suddenly see dark, floating spots or streaks that look like cobwebs, blood vessels may be bleeding inside the eye. Even if the spots clear up on their own, the NEI says it's important to get treatment right away. Call an eye doctor. (NEI)
What happens at a diabetic eye exam
The NEI recommends a comprehensive dilated eye exam at least once a year if you have diabetes. Here is what the AAO says your ophthalmologist may do to check your retina.
1. Dilating your pupils
Drops widen (dilate) your pupils so your ophthalmologist can look through a special lens at the inside of your eye. Plan for blurry, light-sensitive vision for a while afterward, and bring sunglasses.
2. Imaging the retina
Optical coherence tomography (OCT) scans the retina and creates detailed images of its thickness. This helps your doctor find and measure swelling of the macula.
3. Checking blood vessels
Fluorescein angiography uses a yellow dye, injected into a vein in the arm, and a special camera to show whether retinal blood vessels are blocked, leaking or growing abnormally.
4. Treatment options
Treatment depends on what your ophthalmologist finds. The NEI lists injections, laser treatment and surgery as the main options. Learn more on our diabetic retinopathy treatment page.
5. Managing your diabetes
The NEI says staying physically active, eating healthy and taking your medicine can help prevent or delay vision loss. The AAO adds that controlling blood sugar and blood pressure can stop vision loss. (AAO)
Diabetes eye-care checklist
- A comprehensive dilated eye exam at least once a year
- An eye exam as soon as possible if you're pregnant and have diabetes
- Keep blood sugar and blood pressure in your target range
- Stay active, eat healthy and take your medicine as prescribed
- Call an eye doctor right away about new floaters or vision changes
- Bring your medication list and recent lab results to your visit
Diabetic eye care in Southern Utah
Mountain Eye Institute provides treatment of diabetic retinopathy in Cedar City, along with care for glaucoma and cataracts. If your vision is changing, our Cedar City Optical Center can help with glasses once your eyes have been checked.
Spending time outdoors? Read our sun safety guide for your eyes, or learn more about our Cedar City ophthalmology practice. Not sure when you last had your eyes checked? See our guide to how often you should get an eye exam.
Sources
This article is for general education and isn't a substitute for advice from your eye doctor.
Time for your yearly diabetic eye exam?
Our team can check your eyes for signs of diabetic eye disease and talk through what's next.
