Eyes contain a large amount of collagen, nerve, and blood vessel tissue. Some of the body’s smallest and most easily damaged blood vessels are here. High glucose levels in the blood moving through the eyes can damage these tiny blood vessels. This damage along with related bleeding and possible scarring of the retina is called diabetic retinopathy. Studies have shown that up to 45 per cent of all people with diabetes suffer some diabetic retinopathy. Fifteen per cent have enough damage to harm their vision.
Diabetes is one of the leading causes of blindness in North America. Those with diabetes should see an experienced eye doctor at least once a year to prevent eye and vision-related complications.
Type 1 diabetes often surfaces during youth and is usually treated with insulin. Type 2, usually developing after the age of 40, is often associated with obesity. It can often be treated with lifestyle changes and with oral medications. Both types of diabetes can dramatically affect the eyes, causing problems such as cataracts, blurry vision, and hemorrhages in the retina.
If you have diabetes, an eye care professional (optometrist or ophthalmologist) should examine your eyes every year. The cornea, iris (colored part), lens, retina and optic nerve should all be checked. Eye exams include tests for refraction (how your eye focuses using light), glaucoma (for increased pressure inside the eyeball) and general eye health.
A dilated retinal exam is also needed to check the back of the eye. Drops are put into the eyes that make the pupils enlarge. The doctor then has a clear view into the back of the eye. The retina is examined to see if any small hemorrhages are developing there.
The eye is the only place in the body where these tissues can be viewed without cutting through the skin. Any damage within the eye reflects the health of other body tissues and should be monitored closely. The eye doctor will send a report to your family doctor about any changes. If necessary, you can be referred to an eye and retina specialist or surgeon.
Several factors increase the chance of developing eye complications for those with diabetes. They include smoking, and having high blood pressure, high cholesterol levels or high blood glucose levels. Those of Aboriginal, Hispanic, Asian and African descent are at a higher risk of developing diabetes and eye problems.
The type of diabetes and length of the condition are the two most important factors in diabetic retinopathy. People with type 1 usually develop diabetes at a younger age and so have the highest likelihood of retinopathy. Those who experience high blood glucose levels, especially over long periods of time, are also more likely to develop retinopathy.
Studies have shown that keeping blood glucose levels within target ranges dramatically reduces the chances of retinopathy and slow the progression of disease. Talk to your diabetes health care team if you are unsure of your personal ranges. Anyone with diabetes who is developing significant hemorrhages in the retina (proliferative diabetic retinopathy) will be referred to a retinal specialist or surgeon(retinal ophthalmologist). Treatments such as laser photocoagulation to areas of leakage may be needed. Close follow-up and timely treatment can help avert more serious eye complications.
Control of blood glucose levels and regular visits to your eye doctor are key to preventing eye-related complications of diabetes. Your eye doctor will work with the family doctor and other specialists to make sure your visual system is healthy. Prevention and early treatment are vital to protecting your vision.