Diabetes and The Eye

Diabetes (diabetes mellitus), which affects over 21 million Americans, is now the leading cause of blindness among working age adults in the United States. It can affect the eye and while some conditions may be mild and self-limited, other may be severe and cause visual loss. The problem is that treatment is most successful when begun early and in fact, many conditions may not present symptoms until the condition is very far advanced. Hence, the importance of routine yearly comprehensive dilated eye examinations by an ophthalmologist cannot be overstated.

What are the more common ocular complications of diabetes?

Cataracts:  A clouding of the lens of the eye that prevents light from getting to the retina in the back of the eye.

Osmotic lens swelling:  When blood sugar is high, glucose enters the lens causing it to swell resulting in acute nearsightedness. This transient change in vision is reversed as blood sugar is controlled.

Glaucoma:  Optic nerve degeneration resulting in a loss of visual field and leading to blindness related to the intraocular pressure.

Double vision:  Generally due to problems with the small vessels in the nerves leading to the eye muscles, resulting in a lack of coordinated eye movements.

Dry eyes:   Decreased tearing or excess evaporation of the tears.

Diabetic retinopathy:  Probably the most severe of diabetic effects. There are two major types:

Non-proliferative:  Caused by blockage of small blood vessels with resultant micro-aneurisms and leakage in the form of small hemorrhages or exudates.  If leakage occurs into the center of the retina, it results in macular edema with associated decrease in vision.

Proliferative:  Due to more severe blood vessel blockage resulting in the growth of new small abnormal blood vessels in the retina and into the vitreous cavity.  These are fragile and bleed causing vitreous hemorrhage, retinal detachments, scarring and loss of vision.

For more information visit The American Diabetes Association.