What You Need to Know about Diabetic Eye Disease

04 February, 2021
Diabetic eye disease is a term for a group of conditions that usually show no symptoms until the damage is significant. They can affect vision to the point of causing blindness.

High blood sugar is a condition that affects various systems and organs. And it does so silently. Diabetes can lead to diabetic eye disease, a group of eye problems that can affect people with this condition.

Although experts often discuss the cardiovascular impact of diabetes, there isn’t much talk of how it can affect vision. Diabetic eye disease can lead to total blindness. In addition, most of the conditions that comprise it are due to poorly controlled diabetes.

Why does diabetic eye disease occur?

Diabetes is a chronic glucose-related disease. Either the pancreas can’t synthesize enough insulin or the tissues aren’t able to use it correctly.

Insulin is the key substance that allows glucose to enter cells. When it doesn’t do its job, blood glucose levels increase. This damages tissues. According to Mayo Clinic experts, diabetic eye disease occurs because high blood sugar levels damage the blood vessels of the back of the eye (retina).

Diabetes is considered a silent disease that can lead to serious complications if left undetected. In fact, as the National Institute of Diabetes and Digestive and Kidney Diseases points out, its symptoms are often associated with a change in medication or control of the disease.

However, long-term damage occurs even during prediabetes. It’s a period when glucose levels are higher than normal. However, they aren’t high enough to make medical professionals diagnose the disease.

A woman who suffers from diabetes.
Diabetes complications can stem from poor drug control or lack of care for long periods of time.

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Main diabetic eye disease conditions

Diabetic eye disease is a group of eye problems that appear as a result of this disease. The most common are diabetic retinopathy, diabetic macular edema, glaucoma, and cataracts. Below, we explain each of them in detail.

Diabetic retinopathy

Diabetic retinopathy is a condition that results from damage to the blood vessels that carry oxygenated blood to the retina. The retina is the light sensitive layer that lines the interior of the eye (at the back of the eye).

Diabetic retinopathy is one of the most common diabetic eye problems. It usually manifests in stages. As the American Academy of Ophthalmology explains, the first stage is nonproliferative diabetic retinopathy.

What happens is that the blood vessels begin to weaken or leak into the retina. At this time, diabetic macular edema occurs, which commonly causes blurred vision. In some cases, it can lead to ischemia of the blood vessels.

As retinopathy progresses, it reaches the proliferation stage. This stage consists of the growth of new blood vessels (this process is also called neovascularization or angiogenesis). These vessels are weak and can become damaged and bleed.

Bleeding impairs vision. Also, scar tissue can form, making the inside of the eye increasingly opaque. Therefore, light can’t correctly reach the retina.

Diabetic macular edema

Diabetic macular edema is another common diabetic eye disease. In fact, as we explained in the previous section, it usually appears in retinopathy. It’s the accumulation of fluid in the macula, which causes inflammation.

The macula is the area near the center of the retina. It’s responsible for central, high-resolution, color vision. This is why diabetic macular edema can lead to vision loss over time or even blindness.

Glaucoma

This is another very common diabetic eye disease. An increase in pressure inside the eye causes it. The eye’s drainage system is damaged, which makes fluid build up in the front part of the eye.

This damages the optic nerve. As the Mexican Diabetes Federation explains, glaucoma is considered the second leading cause of blindness and the first leading cause of irreversible blindness.

The risk of diabetics suffering from this condition is twice that of healthy people. Symptoms usually appear progressively and vision is gradually lost.

Cataracts

This is a condition that’s also very common in healthy people. In fact, it’s linked to aging. It’s a process of wear and tear in which the lens becomes increasingly hazy.

This makes it difficult to see clearly. Experts consider it another diabetic eye disease because diabetes accelerates the process. In other words, those who suffer from diabetes develop cataracts at a younger age than the rest.

When should you consult a specialist?

Diabetic eye disease is a term for a group of conditions that usually show no symptoms until the damage is significant. That’s why experts consider it essential for diabetics to undergo comprehensive eye exams routinely.

According to the Centers for Disease Control and Prevention (CDC), almost all diabetic eye problems can be prevented. To do so, it’s essential to detect the alteration early and begin to strictly control blood sugar levels.

Medical professionals recommend all those diagnosed with diabetes to get tests, such as an ophthalmoscopy, at least once a year. In fact, it’s essential for those who also suffer from hypertension or high cholesterol levels to get these tests more often.

Having consistently high blood sugar levels increases the risk of diabetic eye disease. That’s why it’s essential for diabetics to control their blood sugar levels throughout the day. This way, they can adjust their treatment to avoid blood sugar spikes.

What you must remember is that, if you’ve been diagnosed with diabetes or prediabetes, medical consultations and controls are essential. Don’t wait to suffer symptoms or complications to go and see your doctor.

Fundus of the eye.
An ophthalmoscopy is a test that allows doctors to see the retina and evaluate the condition of the arteries.

Treatment of diabetic eye disease

Drugs can treat the early stages of diabetic retinopathy. The most used are anti-VEGF agents and corticosteroids. The former reduce the proliferation of blood vessels around the retina. Medical professionals inject them into the eye. In addition, they also reduce macular edema.

Corticosteroids control swelling of the edema. However, some cases don’t respond to drugs and require surgery. According to the Hospital Clinic de Barcelona, ​medical professionals must resort to surgery in these cases:

  • Very dense or recurrent vitreous hemorrhage
  • Macular edema that doesn’t respond to treatment
  • Retinal detachment

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Diabetes is a silent disease

Diabetic eye disease is a group of conditions that result from poor glycemic control, especially in people who were diagnosed with diabetes many years ago. The most important thing to highlight about these conditions is that most of them are preventable.

For this reason, it’s essential for these patients to go see their doctor on a semi-annual or annual basis. In addition, following all the dietary and lifestyle recommendations can reduce the incidence.

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