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Diabetes and the Eye

Diabetes is a growing concern for healthcare providers around the country and this includes eye care providers.  In the United States, diabetic complications are the leading cause of blindness in people ages 20-74 years old.  In the eye, complications due to diabetes are referred to as “diabetic retinopathy”. Retinopathy associated with diabetes is a result of blood vessels weakening and causing hemorrhaging (bleeding) throughout the eye.  Retinopathy can also be an indication of what is happening to the blood vessels in the rest of the body.  An eye exam provides the unique opportunity for a doctor to assess your blood vessels without expensive imaging or invasive procedures.  If a patient has bleeding in their eye, they may also have bleeding in their kidneys.

Annual dilated eye examinations are recommended for all diabetic patients. Studies have shown that only 60% of patients with diabetes have an annual eye examination.   If every diabetic patient in the United States received annual eye examinations it has been estimated that $624 million dollars in health care costs would be saved. Additionally, 400,000 fewer people would lose vision due to diabetic changes in the eye. 

Retinopathy is more likely to occur the longer a patient has had diabetes as well as with uncontrolled blood glucose.  In type II diabetic patients, every 1% decrease in their HgbA1C results in a 35% reduction in the risk for retinopathy.  Unfortunately 5-10% of patients with no signs of retinopathy will progress to retinopathy within the following year, regardless of the level of blood sugar control. This is one reason why it is important for every diabetic patient to have yearly dilated eye exams, even if they have no history of bleeding in the eye and have good control of blood sugar.

Quick facts on diabetes from the Center for Disease Control (CDC)

  • 23.6 million Americans have diabetes. Of those, 17.9 million individuals are diagnosed and 5.7 million are undiagnosed.
  • African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications.
  • Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.
  • More than 60% of non-traumatic lower-limb amputations occur in people with diabetes.
  • In 2007, an estimated $116 billion was spent on direct care for patients with diabetes.

Some of the earliest changes due to diabetes occur in the eyes

The early stages of diabetes, before symptoms are present, can be diagnosed during a dilated eye exam. If you haven't had a dilated eye exam within the past 12 months, schedule yours today.


If you have diabetes, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send images to the brain. The damage to retinal vessels is referred to as diabetic retinopathy.

 

Diabetes is the leading cause of new cases of blindness among adults aged 20 to 74 years.

In 2007, the Centers for Disease Control and Prevention (CDC) estimated that 23.6 million people in the United States have diabetes. In 2006, the CDC listed diabetes as the seventh leading cause of mortality in the United States.

 

Type 2 diabetes accounts for approximately 90% to 95% of all cases of diabetes among American adults. Most alarming, however, is that we are now experiencing a measureable increase in new reported cases of type 2 diabetes among individuals aged 10 to 19 years of age.

 

When to schedule an examination:

  • People with diabetes should schedule eye examinations at least once a year. More frequent eye examinations may be necessary after the diagnosis of diabetic retinopathy.

  • Pregnant women with diabetes should schedule an appointment for an eye examination in the first trimester because retinopathy can progress quickly during pregnancy.

     

If you need to be examined for glasses or contact lenses, it is important that your blood sugar be in consistent control for several days when you see our doctor. Eyeglass and contact lens prescriptions that work well when the blood sugar is stable may not work when sugar levels are out of control.

 

Rapid changes in blood sugar can cause fluctuating vision in both eyes even if retinopathy is not present.

 

There are multiple types of diabetic retinopathy that include:

  • Non-proliferative diabetic retinopathy
  • Proliferative diabetic retinopathy

Learn more about both types of diabetic retinopathy in the videos below

Non-Proliferative Diabetic Retinopathy

Proliferative Diabetic Retinopathy

You should have your eyes checked promptly if you have visual changes that:

1) Affect only one eye.

 

2) Last more than a few days.

 

3) Are not associated with a change in blood sugar levels.

 

 

When you are diagnosed with diabetes, you should have your eyes checked as soon as possible to establish a baseline and then yearly thereafter.

Treatment of Diabetic Retinopathy

Don't lose your sight to diabetes