Diabetic Retinopathy and Diabetes-Related Eye Problems

Diabetic eye problems are among the primary causes of blindness in Americans between the ages of 18 and 65. If you have been diagnosed with Diabetes for some time, damage to your eyes is one of the most pressing problems that you need to be concerned about. Diabetic retinopathy refers to damage to the retina that occurs as diabetes takes its toll over time. Both Type I and Type II Diabetics are at risk for developing these diabetic eye problems just as they are for other forms of diabetic neuropathy.

What Causes the Disorder?

Diabetic retinopathy is caused when there has been damage to your blood vessels in the retina. The retina is the part of your eye, inside at the back, that is responsible for translating what you see into signals the brain can understand. Your blood vessels in your eye are basically under assault, especially if your blood sugar is out of control, and your eye can be greatly impacted by changes in the blood vessels in your eye.

The first type of retinopathy that typically will occur is called "nonproliferative." You can get microaneuryisms (spots) if your blood vessels swell or become blocked. Fluid can leak into your eye, and small amounts of bleeding can be a problem.These events can very much impact your eyesight or aggravate your diabetic eye problem.

More problematic is the more chronic long term retinopathy that is called proliferative retinopathy.This problem occurs as new blood vessels emerge in the eye. These new blood vessels are fragile and can sometimes bleed. You get blood in your eye. The result of this hemorrhaging is that scar tissue forms in the retina or the eyeball that interferes with your vision.

Other more unusual problems in the eyes of diabetics are not discussed here. You should also learn about glaucoma, cataracts, detachment of the retina, and diabetic macular edema.

Blood sugar, Prediabetes and Diabetic Eye Problems

Diabetic retinopathy is related to blood sugar levels in several ways. Diabetics with elevated blood sugars have a better chance of avoiding or minimaized retinopathy if the get tight control of thier blood sugars, especially early on in the disease.

But the relationship between retinal damage and elevated blood sugars is not limited to those with diabetes. Retinopathy and eye problems in prediabetes has also been noted. Somewhere between 8% and 11% of those with prediabetes chave been found to have retinopathy and eye problems even with hemoglobin A1c in the range of the mid 6.0's.

In early and even moderate stages of the progressive eye problems, you may not notice significant changes in your eye sight. One of the most important steps you can take is to have regular eye exams. Your doctor will dilate your eyes with eye drops and examine your retina. Once you have diabetes, an exam every year or so is not a bad idea, and the longer you have had diabetes, the more you need to get regular exams. If you have the more advanced stages of retinopathy, you may be able to reduce by 95% your risk of blindness with treatment.

Near normal blood sugar levels can stave off the retinopathy. Diabetes management stalwarts like diet, exercise and when appropriate medication become all the more important if your eyesight is at risk.

If you can control your blood pressure and cholesterol you can also reduce your likelihood of vision loss.

If you have not already, it is time to give up the cigarettes.

References:

Rosenblatt RJ, Benson WJ. Diabetic Retinopathy. In: Yanoff M, ed. Opthalmology. 2nd ed. St. Louis, MO: Mosby; 2004;877-887.

The Mayo Clinic: Diabetic Retinopathy

National Eye Institute: Facts About Diabetic Retinopathy

Web MD: Diabetic Retinopathy Topic Overview

Photo:

eyeball: eek the cat Eyechart: deege

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