Understanding Eye Conditions Related to Diabetes

If you have diabetes and don’t control your blood sugar, you’re more likely to have eye problems, possibly even blindness. Know your personal risk factors.With diabetes comes an increased risk for vision loss. Diabetes-related eye complications may even eventually lead to blindness, says Raj Maturi, MD, clinical spokesperson for the American Academy of Ophthalmology and a retina specialist at the Midwest Eye Institute in Indianapolis. If you have diabetes, your body doesn’t properly use or store sugar and carbohydrates from the foods you eat. Your blood sugar can fluctuate, and this can damage your blood vessels, including those that supply blood to your eyes. The result can be eye problems that threaten your sight, such as cataracts, glaucoma, and retinopathy.

Diabetes-Related Eye Problems

Normally, the lens of the eye is clear. But it can become cloudy or foggy and make it difficult to focus, Dr. Maturi says. That’s a cataract. People with diabetes are more susceptible to cataracts at a younger age than those who don’t have diabetes are, according to the American Diabetes Association. Also, cataracts often progress faster if you have diabetes. Glaucoma is another eye issue of concern for people with diabetes. Glaucoma can occur if new blood vessels grow on the iris (the colored part of the eye), closing off the fluid flow in the eye and raising the pressure in your eyes. Left untreated, it can cause blindness. According to the NEI, people with diabetes are twice as likely as other adults to get glaucoma. By far the most common eye problem associated with diabetes is retinopathy, Maturi says. Diabetic retinopathy develops when the tiny blood vessels that supply blood to the retina — the thin, light-sensitive tissue at the back of the inner eye — rupture and leak. You may grow new blood vessels, but they’ll be weak and can leak, and can contract or scar, forming a retinal detachment.

Diabetic retinopathy is the leading cause of blindness in adults. In most cases, both eyes are affected. You can have diabetic retinopathy and have no symptoms, or you may notice changes in your vision. “When your blood sugar is very elevated, your vision can become blurry,” Maturi says. The blurry vision can be temporary or long-term. You may also see floaters or spots that drift in your field of vision, which may indicate active bleeding within your eye.

Risk Factors for Diabetes-Related Vision Loss and Blindness

Your chance of developing serious diabetes-related vision problems depends on various issues, including:

Your age. Eye problems like glaucoma and cataracts are more common in older people. With diabetes and age, these vision problems can advance more quickly. The longer you have diabetes, the more susceptible you become to problems that can cause vision loss, especially if your diabetes isn’t well-controlled, says Adrian Vella, MD, an endocrinologist at the Mayo Clinic in Rochester, Minnesota.

Your family history.  “Not everyone with diabetes will have eye complications,” Dr. Vella says. But you may be more susceptible if others in your family have diabetes and eye problems as a result. “There could be a genetic predisposition for complications,” he says. A study published in JAMA Ophthalmology in November 2014 found that African Americans were much more likely to develop diabetic retinopathy than Caucasian people were.

Your blood pressure. High blood pressure can strain your blood vessels, which may already be weakened from diabetes. Work to control your blood pressure by eating a heart-healthy diet, exercising, limiting alcohol and sodium, and not smoking. Keeping your cholesterol down and your weight within a normal range can also help lower your risk for worsening diabetes and vision loss, Vella says.

Smoking. Smoking can increase your blood pressure and make it more difficult to control your diabetes. If you smoke, you should quit.

Symptoms of Diabetes-Related Eye Problems Aren’t Always Obvious

You can develop diabetic retinopathy and other vision problems and have no symptoms. Or you can have symptoms like double vision, low peripheral vision, poor night vision, floaters, and difficulty reading, Maturi says. Your symptoms can be temporary or last longer. “Things can go out of focus for a few minutes or a few hours,” he says.

Don’t wait until symptoms develop to take good care of your eyes. Because there aren’t always early warning signs, Vella says, it’s important to have regular eye exams if you have diabetes. Your eye doctor can detect signs of leaky blood vessels and nerve damage that can lead to vision problems. And to greatly reduce your risk for vision loss, Maturi says, remember that the keys are good diabetes control and early detection and treatment.


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