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How to Prevent Diabetic Vision Loss

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Eye Complications of Diabetes

It’s true. Diabetics have a higher risk of blindness than those without the disease. That fact coupled with the superior prognosis of early intervention, makes it easy to understand why optometrists and doctors say routine eye care is absolutely essential. Below, we’ll discuss what your eye doctor is looking for during a diabetic eye exam.  

As the incidence of diabetes increases, it is important to spread awareness about the risks and proper preventative care for diabetes patients. November is Diabetes Awareness month, so read on!

Diabetics are at greater risk of for a number of eye problems.  

Diabetic Retinopathy:

Diabetic retinopathy is the term used for the disorders associated with diabetes that cause progressive damage to the retina.  The longer a patient has had diabetes, the more likely it is that he will develop these conditions which can be very serious, vision-threatening complications. 

There are two types of retinopathy: nonproliferative and proliferative. 

Nonproliferative retinopathy, which is the most common form, is when capillaries at the back of the eye become weakened and may start to leak blood and fluids. Nonproliferative retinopathy, which often has no symptoms, can be characterized as mild, moderate or severe, depending on how many blood vessels are affected and becoming blocked. This type of retinopathy usually doesn’t require treatment and doesn’t cause vision loss, unless the leaking fluid ends up in the macula where the eye focuses – a condition called macular edema. If this happens, vision can be blurred and even lost so preventative treatment is essential.  

Proliferative retinopathy is much more severe. This is when so much damage is done to the blood vessels that they begin to close off. New blood vessels begin to grow in the retina as a response to this deterioration. The new and weak vessels can leak blood, impairing vision, or can form scar tissue which can distort the retina or cause a retinal detachment.

Proliferative retinopathy requires urgent referral to an ophthalmologist for treatment. While it usually takes years to develop, some instances of proliferative retinopathy can occur within weeks or months if blood sugars are not well-controlled. Pregnancy can also accelerate proliferative retinopathy in known diabetics. Yet if detected early, treatment can be done successfully. 

Like high blood pressure, there are often no warning symptoms until advanced stages of diabetes. It is best to get checked each year by an optometrist. If you experience any changes in your vision such as spots in vision, flashes of light, blurred or double vision (rarely pain), make an appointment with your eye doctor immediately. Treatments do exists for retinopathy and many of them are successful in repairing damage and sometimes even restoring vision.

Cataracts: 

Cataracts are a clouding of the lens of the eye which blocks light from entering and impairs vision. While cataracts are a fairly common and treatable condition, people with diabetes are 60% more likely to develop the condition and often get them at a younger age. Those with the condition also may experience vision fluctuation which occurs from sugar levels affecting the lens of the eye. Cataracts often progress faster in diabetics as well. In serious cases of cataracts, a surgical procedure is done to remove the natural lens of the eye which can sometimes cause complications in diabetic patients that may already have symptoms of other conditions such as diabetic retinopathy.

Glaucoma:

Glaucoma is a serious condition where pressure builds up in the eye causing damage to the retina and optic nerve and eventually if left untreated, blindness.  Diabetics are 40% more likely to develop glaucoma and the risk increases with age and the amount of time the individual has had diabetes. There are treatments for glaucoma including medications and surgery but early detection and treatment are essential to prevent permanent vision loss. Glaucoma is often called the “silent thief of sight” because vision loss often doesn’t occur until significant damage is done. Therefore, yearly eye exams are essential. 

Cornea Alterations:

Diabetics may experience reduced sensitivity in their cornea. This means that contact lens wearers that are diabetics should be more cautious, as they develop higher tolerance if the lens irritates the eyes and may be at greater risk of infection. 

Eye Muscle Disturbance:

More advanced diabetes cases can show restriction of eye muscle movement due to nerve palsy. 

For diabetics, the key to early detection and treatment – and therefore preserving your vision – is to have your eye health monitored on a regular basis. Get your eyes examined every year by an optometrist and if you experience any changes in your vision such as spots, floaters, blurred vision or pain, make an appointment with your eye doctor immediately. 

Written by Dr. David Williams O.D.

Dr. David J. Williams is originally from Columbus, OH, but made his initial voyage to Southwest Ohio for his undergraduate studies. He obtained his Bachelor of Arts degree from Miami University, then attended The Ohio State University College of Optometry. He graduated as the recipient of the esteemed Patient Care Excellence Award in recognition for Exceptional Clinical Skills. After graduating, he moved to Cincinnati to begin practicing in private, commercial, and refractive surgical settings. While honing his clinical skills, Dr. Williams discovered a strong passion for business operations and team building that ultimately drove him back to school. He earned his MBA with a concentration in Finance. He utilized these skills to earn awards in practice excellence and service leadership before deciding to venture out and create 2020 Eyecare with Dr. Gibberman. Dr. Williams has a keen interest in specialty contact lens fitting, diagnosing and treating dry eye disease and glaucoma, and co-managing LASIK and PRK. He also enjoys providing comprehensive eye care for a host of diseases and ocular conditions, including diabetic retinopathy, macular degeneration, anterior uveitis, and other anterior segment conditions. In his free time, Dr. Williams enjoys spending time with his wife Grace, dog Barrett, golfing, reading non-fiction, watching The Ohio State Buckeyes beat up on other Big Ten Teams, and traveling the world.
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