Diabetic Eye Disease
People with diabetes are at elevated risk for several types of eye disease, including retinopathy, cataracts and glaucoma. Eventually, any of these can lead to blindness. Fortunately, all may be avoided or lessened if detected early.
- People with diabetes are 40% more likely to develop glaucoma and are 60% more likely to have cataracts than other adults.1
- Diabetes is the leading cause of new cases of blindness in U.S. adults between 20 and 75 years.2
- Keeping your blood glucose level closer to normal can prevent or delay the onset of diabetic eye disease.3
Retinopathy, the most common eye disease for people with diabetes, is caused by damage to the blood vessels of the retina. In some cases, these vessels may swell and leak fluid. This is called "nonproliferative," or background, retinopathy. As these areas heal, scarring occurs and abnormal new blood vessels may grow on the retina's surface, causing vision loss or blindness. This is called "proliferative" retinopathy and has more serious consequences. Unfortunately, some level of retinopathy is very common, especially for people who have had diabetes for many years. But with good blood sugar control, it doesn't have to affect your vision.
Cataracts cloud the lens of the eye. They are often an early complication of diabetes. It is very important to have an annual eye exam so cataracts can be detected before they become severe.
Glaucoma is an increase in fluid pressure inside the eye. This can damage the optic nerve and lead to vision loss. Glaucoma is more common in people with type 2 diabetes.
Risk Factors for Eye Disease
- high blood sugar levels
- diabetes combined with high blood pressure
- high cholesterol
If you are a woman, your risk is increased during pregnancy.
- diabetes—type 1 or type 2
- women face a higher risk than men, especially women who started menstruating late
- people who are nearsighted and those with brown eyes may be at higher than average risk
- people who are obese
- people who have been exposed to even low-level UVB radiation from sunlight
- smoking can as much as double your risk
- chronic drinkers are at high risk
- age: about 70% of people over age 65 may have opaque areas, and 18% are likely to have cataracts
- race: African Americans and Hispanics are at higher risk than the general population
And, as mentioned above, people with type 2 diabetes are at an increased risk for glaucoma.
Reducing Your Risk for Eye Disease
In a few steps, you may greatly reduce your risk of diabetes-related eye disease.
Achieve tight blood sugar control. As average blood sugar levels rise, so does the risk of retinopathy. Typically, the tighter a person's blood sugar control, the slower the onset and progression of retinopathy. A ten-year study that ended in 1993, the Diabetes Control and Complications Trial (DCCT), found that type 1 diabetics who practiced tighter blood sugar control experienced 76% less eye damage than those who did not.2 Practicing tight control can also decrease your chances of getting cataracts.
Reduce your blood pressure. High blood pressure increases the risk of severe retinopathy.4
Stop smoking. Smoking raises your risk of cataracts and a host of other diabetes-related complications.6
Get an annual dilated-eye exam. People with diabetic eye disease often have no symptoms or pain until the disease becomes advanced—but your eye doctor can detect retinopathy before you have any vision problems. A dilated-eye exam allows your doctor to examine the blood vessels in the back of the eye. The earlier retinopathy is diagnosed, the better your chances for preventing further damage to your eyes. You'll want to have a dilated-eye exam once every year.7
Eye Disease Treatments
Retinopathy. Laser surgery can effectively treat retinopathy by shrinking the abnormal vessels in the retina, repairing leaking vessels or eradicating those that can't be fixed. However, laser surgery may not restore vision that is already lost. That's why it's important to detect retinopathy early and treat it as soon as possible.
Cataracts. Ninety-five percent or more of all cataract surgeries—which involve replacing the lens of the eye with an artificial lens—result in improved vision.8
Glaucoma. Eye drops, laser treatments and laser surgery are often very successful—the treatment depends on the type of glaucoma.
1
American Diabetes Association. "Eye Complications." Available at: http://diabetes.org/type-1-diabetes/eye-complications.jsp. Accessed February 20, 2008.
2
American Diabetes Association. "Diabetes and Retinopathy (Eye Complications)." Available at: http://www.diabetes.org/diabetes-statistics/eye-complications.jsp. Accessed February 20, 2008.
3
Centers for Disease Control and Prevention. "Frequently Asked Questions. Diabetes-Related Health Concerns: How can I keep my eyes healthy if I have diabetes?" Available at: http://www.cdc.gov/diabetes/faq/concerns.htm#5. Accessed February 20, 2008.
4
WebMD, Diabetes Health Center. "Diabetic Retinopathy—What Increases Your Risk?" Available at: http://diabetes.webmd.com/tc/diabetic-retinopathy-what-increases-your-risk. Accessed February 20, 2008.
5
University of Maryland Medical Center. "Cataracts." Available at: http://www.umm.edu/patiented/articles/what_risk_factors_cataracts_000026_5.htm. Accessed February 20, 2008.
6
American Diabetes Association. "Smoking." Available at: http://www.diabetes.org/type-1-diabetes/smoking.jsp. Accessed February 20, 2008.
7
American Diabetes Association. "Eye Care." Available at: http://diabetes.org/type-1-diabetes/eye-care.jsp. Accessed February 20, 2008.
8
MedlinePlus. "Cataract Removal." Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002957.htm. Accessed February 20, 2008.