Diabetic Eye Disease
Dr. Abraham is director of vitreoretinal and retinovascular services, at Black Hills Regional Eye Institute, in Rapid City, South Dakota. Introduction Diabetes is a common medical problem which affects the body's ability to regulate blood sugar levels. Over a period of years, high blood sugar will damage small blood vessels in the body and often cause problems such as kidney failure, sensory abnormalities in the hands and feet, and eye problems. The focus of this presentation is to describe how diabetes affects vision, what specific factors contribute to visual loss, and the technological advances that are available today to evaluate and manage diabetic eye disease. Although in the worst cases an individual may suffer permanent loss of vision in one or both eyes, it is important to remember that most diabetics who carefully control their diabetes and get good eye care can prevent many of the visual complications of the disease. Diabetes is present in approximately three percent of Americans, however individuals in special populations such as Native Americans and the elderly are much more likely to suffer from the disease. For example, nearly 50% of some Native American groups are affected, and among the nation's elderly, about 15% are affected. Because one form of diabetes (i.e., adult-onset, or type II diabetes) may be present in a person for several years before the diagnosis is established, some of the preventable complications may already be in the early or moderate stages when the diagnosis is finally made and treatment initiated. What is Diabetes? Diabetes is much more than having an elevated blood sugar level. It is a complex endocrine disorder which can affect many aspects of the body's metabolism which in turn have detrimental effects on a variety of vital orga Continue reading >>
Why Do Diabetics Have Poor Vascular Access?
Diabetics have a significantly higher concentration of sugar in the blood than healthy individuals. Because of this, poor circulation is one of the most dangerous consequences of diabetes. People with type 2 diabetes have two to four times the risk of dying from heart disease or having a stroke compared to non-diabetics. More than half of the amputations done in the United States are a consequence of diabetes, and usually the need for an amputation occurs because of damage to the peripheral arteries. Poor circulation from artery damage also causes open skin sores and infections for people with diabetes. Diabetes is a disease that interferes with the body's ability to use and store sugar, which can cause many health problems. Too much sugar in the blood can cause damage throughout the body, including the eyes. Over time, diabetes affects the circulatory system of the retina. Why does diabetes lead to artery damage? Part of the answer is that type 2 diabetics usually have other diseases that place the heart and arteries at risk. People with type 2 diabetes are more likely than other people to develop high blood pressure, obesity and high cholesterol. Moreover, high levels of glucose (blood sugar) contributes to artery damage for people with diabetes. This was confirmed by long-term health results for people who participated in the Diabetes Control and Complications Trial (DCCT). After nearly 1,200 patients participated in this trial for an average of more than six continuous years, experts followed the progress of these patients and monitored their health. Continue reading >>
Diabetes And Your Eyes
Diabetic eye disease, caused by diabetes, is a leading cause of blindness and vision loss. Because of the high risk for eye disease, all people with type 2 diabetes should receive an annual dilated eye exam. For people with type 1 diabetes, an annual dilated exam is recommended after they have had diabetes for 5 years. Pregnant women with diabetes should see their eye doctor during the first three months of pregnancy and may need follow-up visits. Continue reading >>
Eye Problems & Diabetes
The three major eye problems that people with diabetes need to be aware of are cataracts, glaucoma, and retinopathy. To prevent eye problems, you should: Control your blood glucose. Have your eyes checked at least once a year by an ophthalmologist (eye specialist). Control high blood pressure and lipids. Contact your doctor if any of the following occur: Black spots in your vision Flashes of light "Holes" in your vision Blurred vision Cataracts A cataract is a clouding or fogging of the lens inside the eye. When this happens, light cannot enter the eye and vision is impaired. Blurred vision Glared vision Treatment Surgery followed by glasses, contact lenses, or lens implant Glaucoma Glaucoma is a disease of the optic nerve (the "cable" that connects the eye to the brain and transmits light impulses to the brain). If the pressure inside the eye builds up, it can cause damage to this optic nerve. While most often there are NO symptoms from glaucoma, the following symptoms might occur: Loss of vision or visual field Headaches Eye aches (pain) Halos around lights Blurred vision Watering eyes Treatment Special eye drops Laser therapy Medication Surgery Prevention Have your eye doctor screen for glaucoma annually. Retinopathy Problems with the retina are called diabetic retinopathy. Problems develop as a result of fluid leaking from blood vessels into the eye or abnormal blood vessels formed in the eye. In either case, vision can be affected. If retinopathy is not found early or is not treated, blindness can occur. Sometimes there are no symptoms of retinopathy, but two common symptoms are: Blurred vision Spots or lines in your vision Laser therapy Surgery Injections into eye (advanced retinopathy) Have your eye doctor screen for retinopathy annually. Women with preexisting d Continue reading >>
Diabetes And Your Eyesight
Diabetes is a complex disease resulting from the inability of the body to produce insulin, a hormone that takes sugar out of the blood and into cells where it can be used for energy. Without enough insulin, there is too much sugar in your blood. It’s like having a car full of gas but no key; you have the fuel you need, but can’t start using it. Diabetes affects more than 29 million Americans. The most common form of diabetes is adult-onset diabetes. Adult-onset diabetes typically strikes those who are over 40, overweight and have a sedentary lifestyle. Other risk factors include those with a family history of diabetes and those belonging to certain ethnic groups. Persons of African, Native American, Japanese, Latino or Polynesian descent are more at risk. Diabetic Eye Disease A common complication of diabetes is diabetic eye disease. Diabetic eye disease refers to a group of sight-threatening eye problems that people with diabetes may develop. Glaucoma is one of these diseases. Diabetic eye disease also includes diabetic retinopathy and cataracts. Diabetic retinopathy, a disease which damages the tiny blood vessels in the retina (the light-sensitive tissue that lines the back of the eye) is the most common diabetic eye disease. Diabetic retinopathy affects nearly 7.7 million Americans age 40 and older. A cataract is a clouding of the eye’s lens that results in blurring of normal vision. People with diabetes are nearly twice as likely to develop cataracts as other adults. Cataracts also tend to develop at an earlier age. Diabetes and Glaucoma The relationship between diabetes and open-angle glaucoma (the most common type of glaucoma), has intrigued researchers for years. People with diabetes are twice as likely to develop glaucoma as are non-diabetics, although som Continue reading >>
Diabetic Eye Disease
Patients with diabetes are at a higher risk of developing eye conditions as a complication of their disease. These conditions can lead to vision loss and blindness and include diabetic retinopathy, cataracts and glaucoma. Diabetic retinopathy is actually the leading cause of blindness in the United States. Diabetic eye conditions often develop without any noticeable loss of vision or pain, so significant damage may have occurred by the time patients notice any symptoms. For this reason, it is important for diabetic patients to have their eyes examined at least once a year. Early detection of eye disease can help prevent permanent damage. Diabetic-related eye problems develop from high blood sugar levels, which can cause damage to blood vessels in the eye. Over 40 percent of patients diagnosed with diabetes develop some form of eye disease as a result of their disease. The risk of developing eye problems can be reduced with regular eye exams and by controlling blood sugar levels with a healthy diet and regular exercise. Causes of Diabetic Eye Conditions Diabetic eye conditions develop in the retina as a result of microvascular abnormalities. The tiny blood vessels within the retina develop microaneurysms that, over time, leak blood. As new blood vessels develop to replace the blood vessels that are no longer viable, they also leak blood causing hemorrhages and permanent damage to the retina. While diabetics struggle with a high sugar count in the blood along with insufficient insulin production, it is actually the lack of oxygen in the blood that leads to loss of vision. Diagnosis of Diabetic Eye Conditions Diabetic eye conditions can be detected through a comprehensive eye exam. A comprehensive eye exam involves a visual acuity test to measure vision at various distance Continue reading >>
Diabetic Eye Disease
A A A Do I need to follow-up with my doctor after being diagnosed with diabetic eye disease? Diabetes is one of the leading causes of irreversible blindness worldwide, and, in the United States, it is the most common cause of blindness in people younger than 65 years of age. Diabetic eye disease also encompasses a wide range of other eye problems, for example, Diabetes may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision. Some people may not even realize they have had diabetes for several years until they begin to experience problems with their eyes or vision. Diabetes also may result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs. The American Diabetes Association estimates that 29.1 million people in the United States have diabetes, and 8.1 million people additional people went undiagnosed. (This population is unaware that they have diabetes.) In the United States 1.2 million new cases of diabetes are diagnosed every year. In the US in 2012, the total annual cost of diagnosed diabetes was 2.45 billion. Eighty-six million people in the US have prediabetes, and 9 out of every 10 don't know they have it. Of the 86 million people with prediabetes, without lifestyle changes 15% to 30% of them will develop type 2 diabetes within 5 years. Lifestyle management has been shown to reduce the risk of developing type 2 diabetes and prediabetes by at least two-thirds. It can also slow or halt the progression of prediabetes to diabetes. People can try to avoid the problems associated with diabetes, including those that affect the eyes, by taking appropriate care of themselves by the following: Maintain a normal level of weight Watch your diet, especially limiting unhealthy types of fats and Continue reading >>
Vision Facts For Children With Diabetes
Diabetes and Your Child's Eyes Diabetes mellitus (mel-i-tuhs) is a disorder caused by a decreased production of insulin or by the body’s inability to use insulin. Insulin is produced by the pancreas and is necessary for the body’s control of blood sugar. Fluctuations in blood sugar can be harmful to the body, including the eyes. Type 1 diabetes (insulin-dependent or juvenile diabetes) can occur at any age, but most commonly is diagnosed from infancy to the late 30s. In this type of diabetes, a person's pancreas produces little or no insulin. Children with diabetes are at risk of developing eye disease that can affect their vision. Diabetic eye disease refers to a group of eye problems that affects those with diabetes. Diabetic eye disease may include: Diabetic retinopathy (ret-in-AHP-uh-thee) A potentially blinding condition in which the blood vessels inside the retina become damaged from the high blood sugar levels associated with diabetes. This leads to the leakage of fluids into the retina and the obstruction of blood flow. Both may cause vision loss. Diabetic retinopathy is the most common and most serious eye-related complication of diabetes. It is a progressive disease that destroys small blood vessels in the retina, eventually causing vision problems. In its most advanced form (known as “proliferative retinopathy”) it can cause blindness. Nearly all people with juvenile (type 1) diabetes show some symptoms of diabetic retinopathy usually after about 20 years of living with diabetes; approximately 20 to 30 percent of them developed the advanced form. Those with type 2 diabetes are also at increased risk. Cataract (kat-uh-rakt) A clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or yellowed. Cataract may occur at Continue reading >>
Blurry Vision And Diabetes: What's The Connection?
Blurry vision is being unable to see the fine details. Another way of describing it is seeing a lack of sharpness. Blurred eyesight is similar to seeing things as if they are in the out-of-focus parts of a photograph. The blurriness can be subtle or obvious, can change through the day, and can come on slowly or quickly. It depends on the cause. Diabetes can cause blurry vision for a variety of reasons. Both short-term and long-term complications can affect the vision of someone with diabetes. Contents of this article: How does diabetes affect the eyes? Long-term uncontrolled diabetes can lead to high blood sugar levels that cause damage to small blood vessels over time. This damage can lead to problems with part of the eye called the retina which can create blurred vision. Short-term blurriness in people with diabetes is due to a different cause. Fluid shifts into and out of the eye due to high blood sugar levels, causing the lens of the eye to swell. This change in its shape causes blurriness as the lens is the part that focuses light onto the back of the eye. This short-term issue will resolve once blood sugar levels are lowered. Can diabetes treatment cause blurriness? Diabetes can also cause short-term blurriness if blood sugar levels fall too low (hypoglycemia). This can happen due to the timing of food or a change in activity levels in people who take medication that increases insulin in the body. Rather than being caused by changes in the eye, blurriness from low blood sugars is caused by the effects of hypoglycemia on the brain. Vision affected in this way will return to normal after glucose levels return to normal. Is blurry vision with diabetes temporary? As stated above, blurry vision can be caused by both short-term and long-term complications of diabetes. L Continue reading >>
Questions / Comments: Please Include Non-medical Questions And Correspondence Only.
Diabetes mellitus is the leading cause of new cases of legal blindness in working age Americans. It is estimated that 14 million Americans have diabetes, but that only one half of these are aware of it. This page discusses ocular complications of diabetes, and their treatment. These sections are not intended to replace the professional examination and diagnosis by a physician, and they are presented here purely for informational purposes. All possible diagnoses and treatment options are not covered, and the information discussed should not be taken as a recommendation to self-diagnose and self-treat a condition. A misdiagnosed or improperly treated eye condition can result in a permanent loss of vision, or a permanent loss of function of the eye or visual system. In the case of any eye problem, seek medical attention promptly. This can include emergency room treatment, as well as treatment by a medical physician or eyecare provider. The doctors of Richmond Eye Associates perform extensive comprehensive eye examinations to check for all possible ocular complications of diabetes mellitus. The most common specific ocular complication of diabetes is diabetic retinopathy, which can even occur in patients who have diet controlled diabetes and "pre-diabetes". Diabetic retinopathy can treated and reversed, especially if caught in the early stages, so it is generally recommended for diabetics to have a dilated comprehensive eye examination annually. Diabetes can also increase the risk for other ocular conditions such as cataracts and glaucoma. These will be screened for at the time of the comprehensive diabetic eye examination as well. Ancillary testing such as fundus photography and optical coherence tomography may also be used when indicated at the time of the examination Diab Continue reading >>
Diabetes And Diabetic Retinopathy: Q&a
Q&A Menu To find the Q&As most helpful to you, please click on one of these subjects: How Does Diabetes Affect Eyes? Q: How does diabetes affect your eyes? — L.L., Connecticut A: Diabetes causes problems in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneurysms and leak blood. New blood vessel growth (neovascularization) occurs. Unfortunately, these blood vessels are weak and also leak. These leaks (hemorrhages) can cause irreversible damage to the retina and permanent vision loss. Patients with controlled diabetes do better than those with uncontrolled diabetes. However, even a person whose diabetes is under perfect control can still develop diabetic retinopathy — hence, the need for yearly retinal exams. — Dr. Slonim Q: Does diabetic retinopathy get progressively worse? — F.R. A: Yes. When left unrecognized and untreated, diabetic retinopathy can get worse and eventually lead to blindness. Diabetic retinopathy can even get worse despite use of the best treatments that currently exist for it. — Dr. Slonim Q: My father has type 2 diabetes and he is seeing double. We went to the hospital about a week ago and they said the diabetes had affected a nerve on the right eye. Can medicine get his sight back to normal? — W.C. A: Diabetes can affect any one of the three cranial nerves that are responsible for movement of the eyes. Diabetes is one of the more common conditions associated with sixth nerve (Abducens nerve) palsies. Paralysis of this nerve affects the lateral rectus muscle that allows the eye to look outward. There is no specific medicine for this. The paralysis can be temporary and last a few months or it can be permanent. — Dr. Slonim Q: Can diabetes cause you to have eye infections suc Continue reading >>
Understanding Diabetic Eye Conditions
Type 2 diabetes can have a terrible impact on your eye health. Learn about the major diabetic eye diseases and get tips for avoiding them. Type 2 diabetes is a systemic disease, and if left untreated it can cause many serious complications in areas throughout the body — including the eyes. In fact, complications that threaten eye health are among the leading problems that can occur with diabetes and put people with type 2 diabetes at a greater risk of blindness. Preventing eye problems such as diabetic retinopathy, cataracts, and glaucoma hinges, in large part, on successfully managing blood sugar levels. Diabetic Retinopathy Unchecked blood sugar levels that spike and plummet can cause damage to the blood vessels of the eyes, resulting in a condition known as diabetic retinopathy. This is the most common vision problem due to diabetes. Retinopathy targets the retina, the tissue lining the back of the eye wall that perceives the images captured by the eye. There are two main types of diabetic retinopathy: Non-proliferative retinopathy. This is the disease's first stage. "The fluctuations in the blood sugar begin to damage the walls of blood vessels," says Victor H. Gonzalez, MD, founder of Valley Retina Institute in McAllen, Texas, and a volunteer for the American Diabetes Association. "The blood vessels begin to leak." The leakage causes the retina to swell, blurring your vision and causing straight lines to appear wavy as the retina takes on an uneven shape. Proliferative retinopathy. This is the disease's second stage, in which the eye tries to compensate for the loss of blood vessels by forming new ones. These new blood vessels are weak, though, and crowd into the retina. "Unfortunately, the blood vessels begin to grow around the central vision," Dr. Gonzalez says Continue reading >>
What Treatments Are Available For Diabetic Eye Disease?
The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Treatment of diabetic macular edema (swelling or the accumulation of blood and fluids in the macula, the part of the retina that provides sharp central vision), has evolved a great deal in the last five to ten years, and is based on the severity of the edema. At present, there are three options: laser treatment Avastin, Lucentis, or Eylea injection intravitreal steroids: Kenalog, Ozurdex, and Iluvien Laser Treatment This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous, which is the jelly-like substance that fills the inside of the back part of the eye. The doctor administers eye drops to dilate (open up) the pupil and numb the eye before treatment begins. Because lasers cannot restore lost vision, it is critical to maintain regular comprehensive eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease: Focal laser treatment, also called photocoagulation: The retina is treated to stop or slow the leakage of blood and fluid from abnormal blood vessels within the eye. Focal laser, however, can also destroy surrounding healthy retinal tissue as it seals the leakage from abnormal blood vessel growth; therefore, it is not used on blood vessels directly under the macula, the center of the retina. Scatter laser treatment, also called panretinal photocoagulation: The areas of the retina away f Continue reading >>
Could My Diabetes Cause One Of My Eyes To Be Red And Painful?
Diabetes can cause eye problems. Pain or pressure in one or both of your eyes could be a sign of damage to your retinas. Blurry or double vision, dark spots or blank areas and trouble seeing out of the corners of your eyes are other symptoms to watch for. The high blood sugar associated with diabetes, sometimes coupled with high blood pressure, can cause the tiny blood vessels of the eyes to swell and weaken, and possibly leak blood into the vitreous (the gel-like fluid within the eye). This can keep light from reaching the retina. Those damaged blood vessels may also develop scar tissue that could eventually pull the retina away from the back of the eye, a potentially dangerous problem called retinal detachment. You can minimize your risks of eye problems by keeping your diabetes under control. Getting regular eye exams can help you catch problems before they become too serious. Report any unusual eye symptoms to your doctor. It is more common to have red, painful eyes from a viral infection or allergic reaction. Allergies to pollens and dust in the air are the most common cause of red eyes, but this rarely causes pain. An eye infection that can cause red eyes is viral conjunctivitis, or "pink eye." Unfortunately, this infection has to run its course because antibiotics cannot help speed recovery. Serious bacterial infections can start on the surface or behind the eye of a person with diabetes and require strong antibiotics to cure. A common complaint of patients with either viral or bacterial infections is that they wake up in the morning with their eyelashes sticking together from the pus that has collected over the night. If your pain is more like a pressure sensation, then you may have glaucoma (although most glaucoma is painless). Glaucoma is too much pressure in Continue reading >>
On this page: Diabetes and diabetic retinopathy • DR symptoms • Types of diabetic eye disease • Who gets diabetic retinopathy? • Minorities and diabetic eye disease • When is DR a disability? • Eye exam assistance program • Prevention • Diabetic retinopathy videos Diabetic retinopathy — vision-threatening damage to the retina of the eye caused by diabetes — is the leading cause of blindness among working-age Americans. The good news: Diabetic retinopathy often can be prevented with early detection, proper management of your diabetes and routine eye exams performed by your optometrist or ophthalmologist. According to the International Diabetes Federation (IDF), the United States has the highest rate of diabetes among 38 developed nations, with approximately 30 million Americans — roughly 11 percent of the U.S. population between the ages of 20 and 79 — having the disease. About 90 percent of Americans with diabetes have type 2 diabetes, which develops when the the body fails to produce enough insulin — a hormone secreted by the pancreas that enables dietary sugar to enter the cells of the body — or the body becomes resistant to insulin. This causes glucose (sugar) levels in the bloodstream to rise and can eventually damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA). Risk factors for type 2 diabetes include obesity, an unhealthful diet and physical inactivity. Unfortunately, the prevalence of obesity and type 2 diabetes has increased significantly in the United States over the past 30 years. According to data released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2015, there were 1.4 million new cases of diabetes reported in the U.S. in 2014. Though this annual number is d Continue reading >>