What can I do to prevent eye problems in diabetes?

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Keeping your blood sugars in control is the most effective way to prevent eye problems. Blood pressure and cholesterol should also be monitored and controlled. Most importantly, if you smoke you need to stop smoking!

Dr. Jeffrey S. Heier, MD
Ophthalmologist (Eye Specialist)

One of the best ways to protect your vision if you have diabetes is to control your blood glucose levels carefully. Studies found that people with diabetes who keep their blood sugar at near-normal levels cut their risk of developing eye diseases and macular edema by 75 percent. If you have diabetes, also pay careful attention to your blood pressure and cholesterol levels. Levels above normal increase the likelihood that diabetic retinopathy will occur and that it will significantly affect your vision.

Dr. Jack Merendino, MD
Endocrinologist

Diabetes remains one of the most common causes of vision loss. If you have diabetes, it's crucial that you see an ophthalmologist or optometrist at least annually, and the examination needs to include glaucoma screening and a careful examination of your retina.

If your eye doctor thinks that there is evidence of retinal disease, he will refer you to a retina specialist. The specialist may decide you need a fluorescein angiogram. This is a test in which a special dye is injected into a vein; it allows the doctor to see where your blood vessels may be leaking blood or fluid or where there may be aneurysms, small areas of weakness in the vessel walls that cause the vessels to bulge and possibly rupture. If the test confirms any of these problems, you may be a candidate for laser photocoagulation, a treatment that helps seal off leaking vessels.

Laser treatment can also reduce neovascularization, also called proliferative retinopathy. This is a condition in which the retina, which is not getting enough oxygen, makes a hormone called vascular endothelial growth factor, or VEGF. VEGF causes new blood vessels to grow, and it usually helps tissues recover after injury. However, in the eye the new vessels are prone to leak blood and fluid into the retina and surrounding tissues. Laser treatment can often eliminate these vessels. If bleeding into the eye is severe, the person may need a vitrectomy, the surgical removal of the gel in front of the retina. The gel is normally clear but may become clouded by blood. After removal, the gel is replaced with a clear saltwater solution.

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The Best Life Guide to Managing Diabetes and Pre-Diabetes

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There are steps you can take to avoid eye problems if you have diabetes:

  • First and most important, keep your blood sugar levels under tight control. In the Diabetes Control and Complications Trial, people on standard diabetes treatment got retinopathy four times as often as people who kept their blood sugar levels close to normal. In people who already had retinopathy, the condition progressed in the tight-control group only half as often. These impressive results show that you have a lot of control over what happens to your eyes. Also, high blood sugar levels may make your vision temporarily blurry.
  • Second, bring high blood pressure under control. High blood pressure can make eye problems worse.
  • Third, quit smoking.
  • Fourth, see your eye care professional at least once a year for a dilated eye exam. Having your regular doctor look at your eyes is not enough. Nor is having your eyeglass prescription tested by an optician. Only optometrists and ophthalmologists can detect the signs of retinopathy. Only ophthalmologists can treat retinopathy.
  • Fifth, see your eye care professional if:
    • Your vision becomes blurry
    • You have trouble reading signs or books
    • You see double
    • One or both of your eyes hurt
    • Your eyes get red and stay that way
    • You feel pressure in your eye
    • You see spots or floaters
    • Straight lines do not look straight
    • You can't see things at the side as you used to

To prevent diabetes-related eye problems, you can do as follows:

Keep your blood glucose and blood pressure (BP) as close to normal as you can.Have an eye care professional examine your eyes once a year. Have this exam even if your vision is okay. The eye care professional will use drops to make the black part of your eyes-pupils-bigger. This process is called dilating your pupil, which allows the eye care professional to see the back of your eye. Finding eye problems early and getting treatment right away will help prevent more serious problems later on. Ask your eye care professional to check for signs of cataracts and glaucoma. If you are planning to get pregnant soon, ask your doctor if you should have an eye exam. If you are pregnant and have diabetes, see an eye care professional during your first three months of pregnancy. Don't smoke.

This answer is based on source information from the National Diabetes Information Clearinghouse (NDIC).

Continue Learning about Diabetic Retinopathy (Eye Damage)

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.