The Link Between Diabetes and Eye Health

Diabetes can damage the tiny blood vessels at the back of your eye. It also raises your risk of glaucoma, cataracts and swelling in the center of the retina. Early damage often causes no symptoms, so a yearly diabetic eye exam is the best way to catch problems while they are easier to treat. Keeping your blood sugar in a healthy range helps protect your vision, too.

Here is how diabetes affects your eyes, what to watch for, and what you can do to keep seeing clearly. You can also read more about our diabetic eye care.

How does diabetes affect the eyes?

Diabetes is a long-term condition that affects how your body makes or uses insulin. Insulin is the hormone that moves sugar from your blood into your cells. When your body doesn't make enough insulin, or doesn't respond to it well, sugar builds up in your blood.

Over time, high blood sugar can damage blood vessels all over your body. The ones in your retina are some of the smallest. The retina is the light-sensitive layer at the back of your eye. It turns what you see into signals for your brain. When its blood vessels are damaged, your vision can suffer.

That is why diabetes and eye problems so often go hand in hand. The good news is that regular exams and good blood sugar control make a real difference.

Can diabetes make my vision blurry?

Yes. Blurry vision is a common eye sign of diabetes. High blood sugar can make the lens inside your eye swell, which changes how it focuses. Your vision may get better or worse from day to day as your blood sugar goes up and down.

If your glasses never seem quite right, or your vision keeps changing, tell your eye doctor and your primary care doctor. Blurry vision can also be a sign of something more serious, so don't ignore it.

Which eye problems are linked to diabetes?

Diabetic retinopathy

Diabetic retinopathy is the most common diabetes-related eye problem. High blood sugar weakens the tiny blood vessels in the retina, and they can leak fluid or blood. In later stages, fragile new vessels can grow and bleed, and scar tissue can form. Without treatment, it can lead to serious vision loss. Early on, it usually has no symptoms at all.

Diabetic macular edema

Diabetic macular edema often grows out of diabetic retinopathy. Fluid collects in the macula, the center of the retina that you use for sharp, detailed vision. This can make reading, driving and recognizing faces harder.

Glaucoma

People with diabetes are more likely to develop glaucoma than people without it. Glaucoma damages the optic nerve, the cable that carries what you see to your brain. It often involves high pressure inside the eye. It usually takes side vision slowly and without pain, so many people don't notice it until damage is done. Eye drops, laser treatment or surgery can lower eye pressure and help protect your sight.

Cataracts

A cataract is a clouding of the lens inside your eye. Most people get cataracts as they age, but people with diabetes tend to get them earlier, and they may get worse faster. Cataracts cause blurry, dim or glary vision. People with diabetes are more likely to need cataract surgery.

What happens at a diabetic eye exam?

A diabetic eye exam goes beyond reading the eye chart. Your doctor looks closely at your retina, its blood vessels and your optic nerve for early signs of damage. This often includes dilating drops, which widen your pupils so your doctor can see more of the retina.

Every patient at Bolt Eye Group also gets retinal photos and corneal topography for a $39 imaging fee. The photos let your doctor confirm that your retina and optic nerve are healthy, and show you what they see. We keep them on file, so even a small change next year stands out.

With an in-office telehealth visit, the same $39 also covers two OCT glaucoma scans, one of the optic nerve and one of the macula. OCT is a scan that uses light to show the layers of the retina in cross-section. It can find swelling in the macula before you notice it. You take all your images home free on the I-Scan Platinum Lifetime Baseline, a credit-card-size USB drive. In-office telehealth is available at every office.

How can I protect my eyes if I have diabetes?

• Get a diabetic eye exam every year, or more often if your eye doctor recommends it.
• Keep your blood sugar in your target range. Check it as often as your doctor advises, and take your medicines as prescribed.
• Keep your blood pressure and cholesterol under control. Both affect the blood vessels in your eyes.
• Eat a balanced diet with vegetables, fruit, lean protein and high-fiber foods. Limit sugary foods and refined carbohydrates. A dietitian can help you build a meal plan.
• Stay active. Regular exercise, even a daily walk, helps your body use insulin better.
• Don't smoke. Smoking raises the risk of diabetic eye disease and many other health problems. Quitting helps at any age.
• Wear sunglasses that block UV rays whenever you are outdoors.

Can diabetic eye disease be treated?

Yes, and treatments keep getting better. Depending on what your doctor finds, treatment may include medicine injected into the eye, laser treatment or surgery. A retina specialist does these treatments. If you need one, we will refer you and help with your follow-up care.

Treatment works best when problems are found early. That is why yearly exams matter, even when your vision seems fine.

When should you see an eye doctor?

Call us right away or go to the emergency room if you notice:

• Sudden loss of vision in one or both eyes
• A curtain or shadow moving over part of your vision
• A sudden shower of new floaters or flashes of light
• Severe eye pain, or sudden double vision

Book a diabetic eye exam soon if it has been more than a year since your last one, if your vision changes from day to day, or if you have blurry spots or trouble reading.

How we do it at Bolt Eye Group

Your doctor checks your retina and optic nerve, reviews your images with you, and explains what they see in plain words. If anything needs treatment, we connect you with a retina specialist.

We see patients at five offices: Canton, East Cobb, Lawrenceville and Riverdale, GA, and Johnson City, TN. We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana. HSA/FSA and CareCredit are welcome.

Frequently asked questions

How often should I have an eye exam if I have diabetes?

Most people with diabetes should have an eye exam at least once a year. Some people need exams more often. Your eye doctor will set the right schedule for you.

My vision is fine. Do I still need a diabetic eye exam?

Yes. Diabetic retinopathy often has no symptoms in its early stages. Your vision can be clear while changes are already happening at the back of your eye.

Can diabetes cause permanent vision loss?

It can, if eye damage isn't found and treated. Yearly exams, good blood sugar control and early treatment lower that risk a great deal.

Book an exam at your nearest Bolt Eye Group office

Don't let diabetes sneak up on your eyes. Book a diabetic eye exam at your nearest Bolt Eye Group office in Canton, East Cobb, Lawrenceville, Riverdale or Johnson City, TN. Find hours and directions on our locations page.