Diabetes can have devastating effects on various organs, and that includes the eyes. In fact, according to one study, 26.43% of diabetics have an eye condition that could result in blindness. But that doesn’t have to be your experience.
In this article, we’ll explore:
- The causes of losing eyesight due to diabetes
- Common symptoms of diabetes-related eye conditions
- Conventional treatment options
- How to protect your vision and overall health naturally
Diabetes eyesight problems: causes and symptoms
Here are the most common eye conditions caused by unmanaged diabetes, and their typical symptoms.
Diabetic retinopathy
Diabetic retinopathy is the leading cause of vision loss for diabetics.
Over time, high blood sugar levels can damage the small blood vessels in the retina–the part of the eye that’s sensitive to light. This damage can lead to blood and fluid leaks, causing retinal tissue to swell.
Over time, this condition can worsen as the retina’s blood supply is cut off, prompting the growth of fragile, abnormal blood vessels that are prone to further leakage.
Diabetic retinopathy symptoms
Initially, symptoms might be absent or mild. But they can progress to:
- Floaters (dark spots, lines, or squiggles in your eyesight)
- Blurry vision
- Dark areas in your vision
- Difficulty perceiving colors
- Blindness, if left untreated
Stages of diabetic retinopathy
Diabetic retinopathy progresses through two main stages:
- Non-proliferative diabetic retinopathy (NPDR): Often the first stage where blood vessels in the retina begin to leak. While vision may not yet be affected, monitoring is crucial.
- Proliferative diabetic retinopathy (PDR): This advanced stage involves the growth of new blood vessels that can bleed easily, potentially leading to retinal detachment and severe vision loss.
While early stages of diabetic retinopathy require only regular monitoring, advanced stages may demand more aggressive treatments, such as surgery.
Diabetic macular edema (DME)
DME is a serious condition that can develop from untreated diabetic retinopathy.
It stems from swelling of the macula, the area of the retina that enables detailed and central vision–vital for activities like reading, driving, and recognizing faces.
With DME, the macula swells due to fluid leakage from blood vessels weakened by high blood sugar levels. While it can occur at any stage of diabetic retinopathy, its likelihood increases as the disease progresses.
Diabetic macular edema symptoms
Early-stage DME often has no noticeable symptoms. However, if untreated, you may notice signs like:
- Blurred vision
- Distorted vision (straight lines appear squiggly)
- Floaters
- Double vision
- Faded or washed-out colors
- Eventually, blindness
Ongoing eye exams are critical for early detection and management of DME.
Branch retinal vein occlusion (BRVO)
BRVO is the second most common retinal vascular disease, primarily resulting from blockages in the retinal veins. These blockages cause blood and fluid to leak into the retina, impairing eyesight.
Several diabetes-related factors increase the risk of BRVO:
- High blood pressure, which is prevalent in diabetics, is a significant contributor.
- Diabetes damages retinal blood vessels, increasing their susceptibility to occlusions.
- Thickened arteries–a consequence of diabetes–can compress and obstruct nearby retinal veins, disrupting blood flow.
- Glaucoma, another eye condition associated with diabetes, heightens the risk of developing BRVO.
BRVO symptoms
The most common symptoms of BRVO include:
- Sudden vision loss
- Blurred vision
- Floaters
- Blind spots in part of the eye
Central retinal vein occlusion (CRVO)
Diabetes also increases the risk of developing CRVO, another severe eye condition resulting from endothelial damage and abnormal blood flow.
CRVO occurs when a blood clot blocks the main vein draining the retina, leaking blood and fluid into the retina. This leakage swells the macula and severely affects central vision.
Over time, the disruption in blood flow can cause nerve cell death, exacerbating vision loss.
CRVO symptoms
The main symptoms of CRVO are:
- Gradual or sudden vision loss or blurriness in one eye, which may worsen over several hours or days
- Floaters
- Pain or increased pressure in the eyes
- In severe cases, complete and immediate vision loss
Cataracts
While cataracts can develop for anyone with age, diabetics have a 2-5 times greater risk–and often get them earlier and more rapidly.
Cataracts cloud the eye’s lens, obscuring vision and making everyday tasks more difficult. Diabetes can contribute to their development in several ways:
- Uncontrolled diabetes can accelerate age-related lens clouding, leading to earlier cataract formation.
- High blood sugar damages the tiny blood vessels that supply the lens.
- The aqueous humor, a fluid that nourishes the lens, can have high glucose levels that cause the lens to swell and become less clear.
- Excess glucose is converted to sorbitol by enzymes in the lens, clouding the lens by affecting its proteins and cells.
Cataract symptoms
Common cataract symptoms include:
- Cloudy, blurry, or dim vision
- Impaired night vision
- Sensitivity to light and glare
- “Halos” around lights
- Frequent prescription eyeglasses or contact changes
Glaucoma
Glaucoma is a group of eye conditions that damage the optic nerve, namely due to high pressure inside the eye.
Compared to non-diabetics, people with diabetes are 36% more likely to develop open-angle glaucoma (a condition in which fluid drains too slowly through the eye’s natural filtration angle, causing buildup). This is the most common type and progresses slowly.
Glaucoma symptoms
In its early stages, open-angle glaucoma may not present any symptoms. As it progresses, you might experience:
- Difficulty seeing in low light or adjusting to changing lighting conditions
- Gradual peripheral vision loss
- Tunnel vision
Other forms of glaucoma may manifest as:
- Headaches
- Eye pain
- Nausea
- Vomiting
It’s crucial to catch this disease early, as symptoms typically appear only when it’s quite advanced.
Vision problems without eye disease
Diabetes can also lead to vision issues without the presence of specific eye diseases. Common symptoms include:
- Blurry vision: Rapid changes in blood sugar levels can change the shape of the eye’s lens, causing temporary blurry vision. This is often one of the earliest signs of diabetes–but fortunately, it’s reversible once blood sugar levels stabilize.
- Double vision: Diabetes can also affect the nerves that control eye movement, potentially leading to double vision as these nerves become damaged.
As you can see, diabetes-related eye conditions can be debilitating if left untreated. See your healthcare provider for routine screenings, and stabilize your blood sugar levels to prevent complications.
Treatments for diabetes-related eye conditions
Conventional medical treatments vary depending on the specific eye condition, but they may include:
- Laser surgery: Focused laser treatments can stop or slow blood and fluid leakage in the eye or shrink abnormal blood vessels. These are used for advanced diabetic retinopathy, BRVO, CRVO, and other severe conditions.
- Other surgeries: Cataract surgery involves removing the cloudy lens and replacing it with an artificial one, restoring vision.
- Vascular endothelial growth factor (VEGF) Inhibitors: These injections reduce retinal swelling and slow the progression of diabetic retinopathy.
- Medicated eye drops: These can reduce eye pressure in glaucoma patients.
- Corticosteroid injections or implants: Steroids like fluocinolone acetonide can be injected or placed as slow-release implants to reduce inflammation.
While these treatments can be effective, they’re quite invasive. That’s why it’s so critical to get regular eye exams and practice healthy lifestyle habits–so you can avoid serious complications and such extreme measures.
How to prevent loss of vision due to diabetes
The best approach to preventing diabetes-related vision loss involves a comprehensive lifestyle strategy, including:
- Diet: Focus on foods that stabilize blood sugar levels, including antioxidant-rich fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid high-sugar, processed foods and saturated fats.
- Exercise: Regular physical activity regulates blood sugar levels and supports blood vessel health, helping to prevent diabetes-related eye problems. It also promotes healthy weight maintenance. Include a mix of cardiovascular and strength-training exercises.
- Avoiding cigarettes: Smoking can elevate blood sugar levels and damage blood vessels–both of which are especially dangerous for diabetics. If you smoke, now is the time to quit.
- Regular eye exams: Annual eye exams are crucial for diabetics. See your healthcare provider regularly–before vision issues arise.
Millions of adults across the globe are at risk of losing their eyesight due to diabetes. But you don’t have to be one of them.
By adopting the healthy lifestyle tips outlined above, getting annual eye exams, and managing your disease, you can reduce the risk of serious complications–and continue seeing all the beauty life has to offer.
References:
Prevalence of Diabetic Retinopathy in the US in 2021
Comprehensive Review of the Effects of Diabetes on Ocular Health – PMC
Diabetic Retinopathy – StatPearls – NCBI Bookshelf
Diabetes and Retinal Vascular Dysfunction – PMC
Diabetic Retinopathy: A Position Statement by the American Diabetes Association – PMC
Laser Treatment Modalities for Diabetic Retinopathy – PMC
Surgical Management of Diabetic Retinopathy – PMC
Managing diabetic macular edema: The leading cause of diabetes blindness – PMC
Update on Current and Future Management for Diabetic Maculopathy | Ophthalmology and Therapy
Branch Retinal Vein Occlusion – StatPearls – NCBI Bookshelf
Cataract in diabetes mellitus – PMC
Comprehensive Review of the Effects of Diabetes on Ocular Health – PMC
Natural Antioxidant Activities of Plants in Preventing Cataractogenesis – PMC
Open Angle Glaucoma – StatPearls – NCBI Bookshelf
What do patients with glaucoma see? Visual symptoms reported by patients with glaucoma.
The Diagnosis and Treatment of Glaucoma – PMC
Diabetic Retinopathy and Diabetic Macular Edema – PMC
Diabetic Macular Edema: Is Your Patient Going Blind? – PMC
Updates on the Clinical Trials in Diabetic Macular Edema – PMC.
Current Treatments for Diabetic Macular Edema – PMC
Weight Reduction as an Adjunctive Management Strategy for Diabetic Retinopathy – PMC
Smoking and diabetes: dangerous liaisons and confusing relationships – PMC
Impact of cigarette smoking in type 2 diabetes development – PMC
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