Diabetes and your eyes

If you’re a member of the Black community, chances are you have, or someone in our immediate family has, diabetes. According to the American Diabetes Association, more than 30.3 million Americans are living with the condition.

According to the American Diabetes Association, in 2015, 30.3 million Americans were living with the condition. At the community level,  12.7% of non-Hispanic Black people had diabetes, a rate that was second only to the 15.1% of American Indians/ Alaskan Natives with diabetes. 

A diabetes discovery can be distressing. Luckily, great strides in managing the disease have been made, like awareness around nutrition and exercise. Even still, almost no one knows that signs of diabetes can be detected early on through an eye exam.

Gabriela Olivares

Gabriela Olivares

November is American Diabetes Month. To recognize it, Dr. Gabriela Olivares, an eye doctor in the VSP network, answers common questions about the connection between diabetes and your eyes. Read and then pass along to a loved one to help them take control of their health.

So, what does an eye doctor have to do with diabetes?

Actually, a comprehensive eye exam can reveal a lot about a patient’s health. Different systemic diseases affect different parts of the body, and diabetes happens to greatly affect the eyes. When you have diabetes, your blood sugar levels are higher than normal, which can cause damage to the blood vessels in the eye. The back of the eye happens to be the only place in the body where you can directly view those blood vessels. Because of the depth of a comprehensive eye exam, if there’s an issue, an eye doctor may be the first to spot it. In fact, signs of diabetes can be detected with a comprehensive eye exam up to seven years before a person shows symptoms of diabetes. That’s why early detection is key.

In addition to spotting warning signs of diabetes, your eye doctor can also detect diabetes-related eye diseases you might already have.

How can my eye doctor help detect diabetes and diabetes-related eye diseases?

A comprehensive eye exam is simple and non-invasive. One way we do this is to dilate your eyes. This process widens your pupil so that your eye doctor can see inside your eye and spot any blood vessel damage. Further, a digital retinal imaging eye exam includes taking a picture of the back of the eye. This way, your eye doctor has an even clearer and more precise picture of your eye to detect diseases faster.

Will I lose my vision to diabetes?

Most diabetes-related vision diseases can be prevented with early detection. However, if you don’t control your blood sugar levels, that can lead to vision loss. Unfortunately, according to the National Eye Health Education Program, diabetes is the most common cause of preventable blindness in adults ages 20-74.

Which are the most common diabetes-related eye diseases? How are they treated?

The treatment of your disease is dependent upon its severity. If your eye doctor detects anything suspicious, you may be referred to your primary care doctor or another specialist. It’s important that you, your primary care specialist, and your eye doctor work together as a team to come up with a personalized care plan to help manage and monitor your overall health.

Some of the most common diabetes-related eye diseases are:

Diabetic Retinopathy - A disease that damages the blood vessels in the retina, resulting in vision impairment. If left untreated, the blood vessels begin to build up pressure in the eye and leak fluid. Some cases of retinopathy can be reversed by controlling your blood sugar, eating healthy and exercising regularly.

Focal Diabetic Macular Edema - An accumulation of fluid in the macula (part of the retina that controls our most detailed vision abilities) due to leaking blood vessels. In order to develop the disease, you must first have diabetic retinopathy.

Diffuse Diabetic Macular Edema – An alternative condition that occurs because of widening or swelling retinal capillaries (very thin blood vessels). 

The treatments for focal and diffuse diseases differ, but they both involve laser procedures. Most eye doctors use focal laser treatment to treat focal diabetic macular edema and grid laser treatment to treat diffuse diabetic macular edema. The goal of both kinds of procedures is to stop the leakage in the macula. 

Open-Angle Glaucoma – Open-angle glaucoma is an imbalance in the production and drainage of the clear fluid that fills the eye between the cornea and iris. The fluid imbalance leads to pressure inside the eye that pushes against the optic nerve, depriving oxygen and nutrients and eventually causing irreversible damage. 

Angle-Closure Glaucoma - Angle-closure glaucoma is caused by a blocked drainage canal, resulting in a sudden rise in eye pressure that can develop very quickly. The symptoms and damage of this type may be more noticeable. 

Glaucoma can be  treated with medication or surgery  to slow or prevent further vision loss. However, vision already lost to the disease can’t be restored. 

Cataracts - Cataracts are a disease in which the eye’s lens turns opaque over time, causing vision to become dim, foggy and blurry. Obscured vision occurs because a clouded lens prevents light from properly focusing onto the retina, which is the part of the eye that communicates what you’re seeing to your brain. Many people say that having cataracts is like looking through a dirty windshield. Cataracts can be treated through surgery.

How can I prevent diabetes-related eye diseases?

The sure-fire best way to prevent diabetes-related eye diseases is to see your eye doctor every year for your comprehensive eye exam, whether you have diabetes or not. Additionally, eat healthy and exercise regularly. Choose a diet rich in nutrients, and low in saturated and trans-fat, calories, cholesterol and sodium. Say yes to good carbs like veggies, beans, and whole grains, and to good fats like nuts, seeds and avocados.

How often should I go to the eye doctor?

If you have normal blood sugar levels, you should see your eye doctor once a year, even if you don’t have any vision issues.

If your eye doctor discovers diabetes in one of your annual comprehensive eye exams, your visits might become more frequent in order to properly manage the disease.

When should I first take my child to the eye doctor?

Unfortunately, most parents wait to schedule an eye exam until their child complains about their vision. However, your child’s first eye exam should be at six months of age. As a Hispanic mom, I’m aware that minorities are more susceptible to diabetes, and so I wholeheartedly believe in this rule. If that first eye exam is normal, the next exam should be at 3 years old and then 5 years old. It’s also important to note that a pediatrician’s exam or vision screening should not substitute for a comprehensive eye exam. Only eye doctors have the training and equipment to perform a thorough eye exam.

For more information, visit vsp.com.

This story has been updated.

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