Diabetes: An Eye Exam Can Save Your Sight

In the U.S., diabetic retinopathy is a leading cause of vision loss among adults often during their most productive years.  It causes up to 24,000 new cases of vision loss each year.

What does diabetes have to do with my eyes and what is Diabetic Retinopathy?

Diabetes can harm your vision, or even cause blindness.  With diabetes, your body does not use and store sugar properly.  High blood sugar levels damage capillaries, small blood vessels connecting arteries and veins.  The damage to the vessels in your eyes is called diabetic retinopathy. 

 What is diabetic retinopathy?

Diabetic retinopathy is the eye disease people with diabetes get most often. It is a major but preventable cause of blindness in adults in the U.S.  The retina at the back of the eye sends the pictures of what we see to the brain. Diabetic retinopathy harms the blood vessels in the retina. These weakened vessels leak fluid, fatty material, or blood.  Abnormal new blood vessels may develop on the surface of the retina, the inside lining of the eye responsible for sight, where they can lead to bleeding. The longer you have diabetes, the more likely you are to get diabetic retinopathy.

 How do I know if I have diabetic retinopathy?

You might not know.  There are often no signs when you first have the disease.  In the early stages when treatment is most effective, your vision will not change much and you will not feel any pain.  The best time to treat diabetic eye disease is before you have any symptoms.  Eye check-ups should be yearly if no retinopathy is present.  Patients with diabetic retinopathy may be requested by their ophthalmologist to come in at more frequent intervals.

Can I delay retinopathy by keeping my blood sugar under control?

A recent national study showed that strict control of blood sugar can delay the onset of retinopathy and can slow the progression of early cases.  All diabetics should strive for good control of their blood sugar because some patients, even those with more advanced diabetic retinopathy, might delay the progression of the disease if their blood sugar is maintained at a reasonable level.  Others, however, will see a progression of the disease even if their blood sugar is normal or near normal.  Weight control is also extremely important.

How do you diagnose it?

In most patients, the ophthalmologist can diagnose diabetic retinopathy during a routine eye examination by dilating the pupils and looking inside the eye.

How do you treat it?

Laser surgery is often recommended.  Multiple laser treatments over time are sometimes necessary.

Is it safe for a woman with diabetic retinopathy to become pregnant?

Most diabetic women can have a baby without an increase in retinopathy.  In some patients, however, the retinopathy may worsen.  It is recommended that all patients be monitored frequently during pregnancy. 

Does high blood pressure affect the eyes?

Some studies have shown that patients with high blood pressure are more likely to have retinopathy.  However, since high blood pressure alone can damage the eyes, heart, kidneys, and brain, patients should keep their blood pressure under control and have it monitored regularly.

Should a person with diabetic retinopathy exercise?

There is no convincing evidence that exercise increases bleeding of the retina.  Moreover, exercise is important not only for general well being, but also for controlling blood sugar levels.  Each patient should continue routine exercise unless he or she notices hemorrhages frequently during exercise, and should consult their personal physician to make sure that there are no medical reasons that would prohibit exercise.

If you have diabetes, it is important that you have your eyes examined by an ophthalmologist annually.

EyeCare America's Diabetes EyeCare Program (DEP) promotes annual, dilated eye exams for seniors with diabetes. DEP raises awareness about diabetic eye disease, including diabetic retinopathy, provides free diabetic eye disease educational materials and provides access to eye care.

 Call 1-800-272-EYES (3937) to get complimentary educational materials on diabetic retinopathy or to find out if you or a loved one is eligible for the Diabetes EyeCare Program.  The help line is open 24 hours a day, seven days a week, 365 days a year. Find out more at www.eyecareamerica.org

William Tasman, M.D , is an ophthalmologist at Wills Eye Hospital in Philadelphia, Pennsylvania. Dr. Tasman is also a member of the Advisory Board of Directors for the Foundation of the American Academy of Ophthalmology.