Diabetes, a disease characterized by high blood glucose levels, can lead to serious eye complications. The changes caused by diabetes aren't obvious until damage has already been done, which is why the American Diabetic Association (ADA) recommends annual eye exams for all diabetics. Diabetics with vision changes should be seen immediately to control problems as quickly as possible.
Non-Proliferative Diabetic Retinopathy
Diabetic retinopathy is damage done to the blood vessels in the retina, the area at the back of the eye that carries nerve impulses to the brain. Early diabetic retinopathy is called non-proliferative retinopathy; in this condition, small blood vessels damaged by high glucose levels may swell and leak. If the swelling is in the macula, the central point of vision on the retina, severe vision loss can occur. Swelling in the macula, called macular edema, is treated with injections of steroids into the eye. Laser treatment can be done if leaking is occurring outside the macula.
Proliferative Diabetic Retinopathy
Non-proliferative retinopathy leads to blood vessels that supply nutrients to the retina being blocked; the eye tries to create new blood vessels on the retina to compensate for the loss of nutrients, but the new blood vessels are fragile and leaky. At this point, diabetic retinopathy is proliferative, meaning that new blood vessels are growing. New leaking blood vessels away from the macula are treated with laser.
Proliferative diabetic retinopathy can also cause macular edema, which is treated with injections into the eye to decrease the formation of abnormal blood vessels with medications called anti-VEGFs. The National Eye Institute reports that diabetics with proliferative retinopathy have less than a 5 percent chance of going blind within five years if treated promptly.
Vitreous Hemorrhage
Proliferative retinopathy can lead to vitreous hemorrhage if the abnormal blood vessels leak blood into the vitreous, the clear jelly that fills the eye and attaches to the retina. If bleeding is severe, no light reaches the retina and complete vision loss occurs. Vitreous hemorrhage may need surgical treatment; the vitreous jelly is removed and replaced with a sterile solution that maintains the eye's shape.
Retinal Detachment
Proliferative diabetes can cause scarring on the surface of the retina; scar tissue can pull the retina away from the wall of the eye, resulting in a retinal detachment. Vision is lost in the area of detachment, which can be partial or complete. Laser or surgery can be used to treat retinal detachment, depending on how extensive the detachment is.
Glaucoma
Glaucoma, or elevated intraocular pressure that damages the optic nerve which transmits signals to the brain, is not a disease found only in diabetics, but diabetes are 40 percent more likely to develop glaucoma, the ADA states, and the risk goes up the longer you have diabetes. Both glaucoma and diabetes are more common in African Americans. Glaucoma can be treated with eye drops.
Cataracts
Cataracts, a clouding of the lens in the eye, are also not found only in diabetics but diabetics have a 60 percent higher risk than those without diabetes.Cataracts can cause blurred vision and can be surgically removed.
