When you have diabetes, high blood sugars can affect different tissues and organs in your body, including your eyes. Diabetes eye problems develop slowly and may range from blurry vision to blindness. Even though it is caused by many conditions, blurry vision may be an early sign of diabetes in those who have not yet been diagnosed with it.

What eye problems can diabetes cause?

High blood sugar levels can affect different parts of your eyes in different ways. The diabetes-related eye conditions may include:

1. Blurry vision

This is the loss of clarity or sharpness of the objects you see. It usually happens when you are changing treatments for your diabetes. Each eye has a flexible, transparent lens which focuses light from objects onto the retina. Too much glucose in the lens increases fluid in it, causing it to swell, making it unable to properly focus on objects.

Blurry vision is temporary and resolves in a few weeks or months when blood sugar levels normalize.

1. Diabetic retinopathy

The retina is a lining at the back of each eye containing special cells which receive light and change it to signals that are sent to the brain. This allows us to understand what we see. Having consistently high blood sugars can affect blood vessels and other cells in your retina. You may notice changes in vision and if the condition is untreated, you can become blind.

Actually, diabetic retinopathy is among the leading causes of preventable blindness in the world, according to the World Health Organization. About a quarter of the patients with diabetes have diabetic retinopathy.

The 2 types of diabetic retinopathy are:

1. Non-proliferative diabetic retinopathy (NPDR): This is the early stage of diabetic neuropathy. Here, damaged blood vessels in your retina weaken, swell, eventually burst and leak.
2. Proliferative diabetic retinopathy (PDR): This a later and more serious stage of diabetic retinopathy. As your condition worsens, less oxygen reaches your retina cells and this triggers formation of new retina blood vessels. These new vessels are fragile and can easily bleed, leading to scarring or pulling off your retina from the back of your eye.

Diabetic retinopathy can be treated with medications injected into the eye, laser treatments, surgery, or a combination of the different treatment options.

1. Diabetic macular edema

The macula is the part at the center of your retina. It is the part you use for central vision and making out the fine detail of what you see. So, it provides the best vision necessary for reading, driving and telling the difference between faces. Macular edema happens when fluid leaks from damaged blood vessels in your retina, causing swelling in your macula.

Macular edema can develop at any stage of diabetic retinopathy. It may cause you reversible partial vision loss or blindness, if severe.

1. Cataracts

A cataract is when your lens becomes cloudy. As you age, it is normal for your lens to become cloudy. If you have diabetes, your lens may cloud at a younger age.

Surgery can be done to treat cataracts. During cataract surgery, the cloudy lens is replaced with an artificial lens.

• Glaucoma

Glaucoma is a group of disorders which slowly damage the optic nerve. The optic nerve is a bundle of nerves which transports signals between your eyes and the brain. In glaucoma, fluid doesn’t drain from your eyes like it should, causing pressure to increase above the normal. There are many types of glaucoma, and open angle glaucoma is the most common.

Glaucoma can be treated with medication that lowers eye pressure, laser treatments or surgery.

What increases the chances of getting diabetes eye disease?

Not everyone with diabetes develops diabetes-related eye problems. But the longer you live with diabetes, the higher the chances that you will develop eye disease. You may also be at a higher risk if you:

• Have poorly controlled blood sugars
• Have high blood pressure
• Have high blood cholesterol levels
• Smoke
• Are pregnant
• Are obese or overweight
• Have kidney disease
• Have certain genes

What are the symptoms of diabetes eye disease?

Diabetes can affect your eyes without causing any symptoms. When symptoms appear, they may include:

• Blurry vision
• Eye pain
• Headache
• Watery eyes
• Poor color vision
• Partial or total vision loss
• Flashes of light
• Floaters, small gray or black spots in your vision

How is diabetes eye disease diagnosed?

Your eye doctor will ask you questions about your symptoms, any medical conditions, and the medications you are taking or have taken in the past. If you self-monitor your blood sugar at home, your doctor may also want to know how well your sugars are controlled.

You need to have yearly eye exams within 5 years after the diagnosis of diabetes. This will help your doctor to identify eye problems earlier. Examination of your eyes may involve:

• A dilated eye exam: To widen your pupils, your doctor will put eye drops in your eyes. A special object with a magnifying glass, called a fundoscope, will be used to see the back of each eye. You will have blurry vision for some time after the dilated eye exam.
• Measuring the pressure in your eyes. A special instrument, called a tonometer, is used.
• Using a chart to check how well you see.

You may also need to have additional blood and urine tests done.

Can diabetes eye disease be prevented?

You can protect yourself from diabetic eye disease, or prevent your eye disease from getting worse by:

• Quitting smoking
• Controlling your blood sugar levels. To do this, you should stick to an appropriate diet plan and adhere to your anti-diabetes medications. Don’t change your medication without approval from your doctor.
• Exercising regularly
• Controlling your blood pressure and blood cholesterol levels
• Having regular eye exams, at least once a year.

What should I remember?

Diabetes eye disease is a serious complication that can lead to vision loss if not properly managed. Regular eye exams are crucial for early detection and treatment, helping to prevent or slow down damage.

Protecting your vision starts with controlling your blood sugar, blood pressure, and cholesterol levels. By taking these steps and staying vigilant about eye care, you can significantly reduce the risk of diabetes-related eye complications and maintain healthy eyesight.