Diabetes and the Eye

When someone is diagnosed with diabetes, their primary care doctor almost immediately will recommend annual eye exams. Often times, the patient will be seeing well and will not understand the need for these eye exams. However, diabetes can affect the eyes in multiple ways. Many of the problems related to diabetes in the eye can be found by exam and the complications prevented before any symptoms arise. Additionally, the eye exam will also help to support the level of blood sugar control. I often tell my diabetic patients: if there is a problem in the eyes then there is also a problem in the kidneys, brain, and legs. Poorly controlled diabetes tends to lead to many complications, and usually at a much faster rate than well-controlled diabetes. I have seen cataracts go from nothing to severe overnight in poorly controlled diabetics. Poorly controlled diabetes can get neovascular glaucoma, and diabetic retinopathy. These conditions can result in permanent vision loss or even blindness in some cases. The overall risk of diabetes damage to the eyes is related to the control of the blood sugar, the amount of time one has had diabetes, and other factors such as high blood pressure, high cholesterol and smoking. Diabetes causes "ischemia" which is another way of saying that it causes reduced blood flow. This reduced blood flow causes most of the resulting complications because the body is trying to counteract this low blood flow. It does this by growing new blood vessels which are often disorganized and can lead to bleeding, retinal swelling, retinal detachment, and glaucoma. When I look into the eye, one of the early signs of diabetes damage will be little out-pouching of blood vessels called microaneurysms. Sometimes these can blur the vision, and other times they can be a sign of damage. As the diabetes becomes worse, there can be small hemorrhages, and areas of dead nerve tissue in the eye. With worsening, the blood vessels can be disorganized in appearance, and finally they can start to grow the wrong way. This can lead to retinal detachment or vision loss due to bleeding. Many times we can intervene with diet modification, stronger blood glucose control, laser or injections to help reduce the risk from these conditions. If you have diabetes and live in Central Texas, Georgetown, or the Austin area, and need an eye exam, please call our office at 512-686-1224 to schedule an appointment.