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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.
According to the American Diabetes Association:
• Improved blood sugar control can prevent or delay diabetes-related 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.
Some people are at an even higher risk of getting retinopathy:
• people with high blood pressure
Others are more likely to get cataracts:
• people who have poor diabetes control
And, as mentioned above, people with type 2 diabetes are at an increased risk for glaucoma.
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 called the Diabetes Control and Complications Trial (DCCT) showed that those who practiced tighter blood sugar control experienced 76% less eye damage than those who did not. Practicing tight control can also decrease your chances of getting cataracts.
Reduce your blood pressure. High blood pressure increases the risk of severe retinopathy.
Stop smoking. Smoking raises your blood pressure, reduces circulation, and is damaging to all your blood vessels.
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, and if you're pregnant, plan to have a dilated eye exam in the first trimester.
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. Cataracts can often be treated with 90 to 95% success, by replacing the lens of the eye with an artificial lens.
Glaucoma. Eye drops, laser treatments, and laser surgery are often very successful - the treatment depends on the type of glaucoma.
1 "Eye Complications" American Diabetes Association
2 Source: National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Department of Health and Human Services, Centers for Disease Control and Prevention.
3 "Diabetes Statistics/Eye Complications" American Diabetes Association
4 "Diabetes Statistics" American Diabetes Association