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Diabetic Retinopathy and Other Eye Problems

What eye problems are often associated with diabetes?

Diabetic eye disease refers to a group of eye problems that may occur in people with diabetes. All can cause severe vision loss or even blindness. Diabetic eye disease can often be treated before vision loss occurs.

Patient having annual eye exam

All people with diabetes should have a dilated eye examination at least once a year.

Diabetic eye diseases include the following:

  • Diabetic retinopathy

  • Cataracts

  • Glaucoma

Diabetic retinopathy is the most common eye disease in people with diabetes.

What is diabetic retinopathy?

Diabetic retinopathy is the leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina, the light-sensitive lining of the eye.

Anatomy of the eye, internal
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In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid, while in others, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

Diabetic retinopathy cannot be completely avoided, but the risk can be greatly reduced. Better control of blood sugar levels slows the onset and progression of retinopathy and reduces the need for laser surgery for severe retinopathy.

What are the symptoms of diabetic retinopathy?

A person with an early stage of diabetic retinopathy may be asymptomatic and without pain. Vision may not change until the disease progresses.

A condition called macular edema is when the macula, a part of the retina, swells from the leaking fluid. This causes blurred vision.

When new vessels grow on the surface of the retina, they tend to be weak and fragile. They can break and bleed into the eye, further decreasing your vision.

Who is at risk for diabetic retinopathy?

Anyone with diabetes is at risk for diabetic retinopathy. The longer a person has diabetes, the more likely he or she will develop diabetic retinopathy.

Can diabetic retinopathy be prevented?

Although diabetic retinopathy cannot be prevented, the risk of developing it can be reduced by:

  • Having a dilated eye examination once a year. An eye exam does not prevent retinopathy, but it can help diagnose eye problems that can then be treated. An eye exam can alert the patient and provider if better control of the diabetes is needed. 

  • Strictly managing diabetes by:

    • Taking medications as directed

    • Using insulin as directed, if needed

    • Eating to manage blood sugar levels

    • Exercising to lower and help the body use blood sugar

    • Testing blood sugar levels regularly

    • Testing urine for ketone levels regularly

    • Regular health care follow-up to evaluate diabetes control and rule out or treat other risk factors, such as high blood pressure and high cholesterol 

    • Quit smoking

What is the treatment for diabetic retinopathy?

Specific treatment for diabetic retinopathy will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Diabetic retinopathy is often treated with lasers to shrink the abnormal blood vessels and/or seal the leaking ones. Other common treatments include intraocular injections and surgery.

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