Diagnosed with Diabetes? See an Ophthalmologist

Diabetes is a chronic medical condition characterized by high blood sugar levels. This condition can cause a range of health issues, including complications related to vision and eye health.

There are a number of preventive steps diabetic patients can take to protect their vision and manage their condition. Patients who have received a diabetes diagnosis, or who have a history of the disease in their family, should include a regular trip to their ophthalmologist for diabetes as part of treatment.

Diabetes is a systemic disease where the body does not break down blood sugar correctly. A normal body turns sugars into a molecule called glucose and releases it into the bloodstream.

As blood sugar goes up, the body releases insulin, which allows cells to take in glucose and use it as energy. Patients with diabetes do not produce enough insulin.

When the body fails to produce sufficient insulin, glucose stays in the bloodstream. This can lead to long-term health problems like heart disease, kidney disease, and vision loss.

High blood sugar levels that accompany diabetes can affect many parts of the body, including the eyes. Most diabetic eye complications are linked to eye vessel damage caused by high blood sugar levels.

The most common diabetic eye conditions are:

Diabetic retinopathy is the most common diabetic eye disease. It is the leading cause of vision loss for people with diabetes. In this condition, high blood sugar levels damage the blood vessels in the retina.

These damaged blood vessels can swell, leak, or close up and prevent blood from passing through. If left untreated, these disruptions can cause vision loss.

Macular edema is a common manifestation of diabetic eye disease where fluid builds up in a part of the retina called the macula. If left untreated, this fluid buildup can lead to swelling, distorted vision, and vision loss.

Many conditions can cause macular edema, but diabetes is one of the most common. High blood sugar levels damage blood vessels and produce leaky fluid that swells up in the macula.

Medical conditions like diabetes can cause cataracts. Outside of aging, diabetes is one of the most common causes of cataracts.

Diabetes-related cataracts often have a faster onset than age-related cataracts.

Glaucoma is a progressive disease that damages the optic nerve. Having diabetes doubles your chances of developing glaucoma.

Many diabetic eye conditions can be managed with an early diagnosis and treatment. To prevent potentially serious consequences such as vision loss, patients should regularly see an ophthalmologist for diabetes.

This is especially important as many diabetic eye conditions don’t show symptoms in their early stages. By the time patients may notice symptoms like blurred or distorted vision, the disease may have progressed and could require more invasive treatment.

The American Diabetes Association has specific recommendations about when patients should visit a doctor based on their diabetes diagnosis:

Type 1 diabetes: Patients diagnosed with type 1 diabetes should have their first eye exam within 5 years of their diagnosis. Following their initial exam, they should have their eyes checked every year.

Type 2 diabetes: Patients with a type 2 diagnosis should receive an eye exam immediately after their diagnosis. Once the initial exam is complete, it is recommended that patients schedule an annual check-up with their ophthalmologist.

Pregnant women with diabetes: Pregnant diabetic patients or patients diagnosed with gestational diabetes should have an exam within their first three months of pregnancy, and another one after a year postpartum.

Prior to their visit, patients can conduct a short self-evaluation to help the doctor detect health problems. Some things for patients to consider:

• Have they noticed any eye problems, such as blurry vision, flashes of light, poor night vision, or double vision?
  

• Do they have trouble judging distances or distinguishing between red and green colors?
  

• Is their vision preventing them from doing certain activities, or impacting their ability to do them?
  

• Have they had any health issues, injuries, operations, changes in medication, or illness since their last visit to the eye doctor?
  

• Does their family have a history of eye problems such as glaucoma or cataracts?

During a visit to the ophthalmologist for diabetes, patients will receive a comprehensive eye exam. In this exam, the ophthalmologist will dilate the patient’s pupils. This allows them to view the retina, and more easily observe common signs of diabetic eye conditions.

The doctor may also conduct a test called a fluorescein angiography. During the test, the doctor will inject a special dye into the patient's bloodstream which allows them to observe damage to the blood vessels.

Depending on the patient's symptoms and medical history, doctors may also conduct tomography scans, glaucoma tests, and a general check-up of the patient’s vision.

While a diabetes diagnosis may be outside a patient’s control, there are a number of steps they can take to manage their condition.

Blood sugar control: Controlling blood sugar levels helps prevent diabetic eye conditions. Patients should follow their doctor's instructions for controlling blood sugar. These may include: monitoring blood glucose levels, taking prescribed medications, or following specific dietary and lifestyle recommendations.

Blood pressure management: High blood pressure often exacerbates diabetic eye conditions. Patients can manage their blood pressure through medication and healthy lifestyle changes.

Healthy lifestyle: A balanced, healthy lifestyle improves circulation and reduces the risk of diabetic eye complications. Some healthy lifestyle changes for diabetics include enjoying a balanced diet, getting regular exercise, and avoiding cigarettes and tobacco.

Medications and procedures: In more serious cases doctors may recommend medications, injections, or laser therapy to manage diabetic eye conditions.