Eye tests and diabetes are two things that don’t seem to go together, but they’re more connected than many would think. Anyone with diabetes knows that managing it can be tricky. Diet and insulin intake are two of the most important parts, but other things can also be affected.
One of those problems is an eye condition called diabetic retinopathy. Here’s how diabetes affects the eyes, how diabetic retinopathy works, and how to manage and prevent further eye problems.
What is the Connection between my Eyes and Diabetes?
What does diabetes have to do with the eyes? There are two different things that can come together to create diabetic eye problems. Those are blood vessels and a part of the eye called the retina.
Blood vessels help to transport glucose and insulin to various parts of the body. [1] Since many diabetics have higher blood sugar levels than normal, the blood vessels transport more sugar than they would normally do. If blood sugar levels are high over a long period of time, blood vessels can become damaged. When blood vessels are damaged, they may grow in unusual ways, become blocked, or leak into the surrounding area. [2]
How does this connect to the eye? One of the most important parts of the eye is the retina, which has many blood vessels running to and from it. The retina is responsible for taking light and bringing it to your brain via electrical signals. When your brain gets those signals, you are able to see what is around you. Just like with any other sets of blood vessels, the ones in the retina can be damaged by diabetes. [3]
What is Diabetic Retinopathy?
Diabetic retinopathy is the eventual result of damage to the blood vessels in the retina. When those vessels become damaged, they affect your vision and can eventually cause blindness. It comes in three different stages: background retinopathy, pre-proliferative retinopathy, and proliferative retinopathy. [4]
Background retinopathy is the first stage and occurs when damage to the blood vessels in the retina causes small bulges to form. [5] These bulges can be detected with an eye exam but otherwise cause no symptoms and do not affect vision.
Background retinopathy is a warning sign that your vision may have problems in the future, and measures should be taken to prevent it from worsening. However, since there are no symptoms, many are unaware they have background retinopathy if they do not have regular eye exams. [6]
Pre-proliferative retinopathy is the next stage and occurs when the damage to the blood vessels causes bleeding inside the retina. [7] When this happens, a part of the retina called the macula can swell, and your vision may blur or have dark spots in your vision. [8]
At this point, symptoms become visible and may cause a diabetic to go to the doctor about them. Treatment at this point usually involves stricter measures to control your diabetes and blood sugar levels. [9]
Proliferative retinopathy, also called advanced retinopathy, is the final stage of diabetic retinopathy. [10] Damage to the blood vessels in the retina has caused them to grow across places they would not normally be. Bleeding from those vessels can also form scar tissue.
These problems can lead to the retina separating from the back of the eye. Symptoms can include complete loss of vision. Treatments usually cannot correct any already lost vision but can prevent the problem from worsening. Laser treatment of the eye or surgery to remove the scarred areas or reattach the retina may be needed. [11]
How do I Know if I have an Eye Problem?
In the earliest stages of diabetic retinopathy, there may be no symptoms at all. The only way that it can be detected is through an eye exam. But if it has progressed to a later stage, there may be several noticeable symptoms. These include:
- Blurred vision
- Dark spots or shapes in front of the eyes (sometimes called floaters)
- Sudden loss of vision
- Trouble seeing colors
- Blind spots
- Difficulty reading or seeing objects up close
How can my Optician Detect Diabetes?
It is possible for an optician to detect signs of diabetic retinopathy in the eyes during some ordinary eye exams, even before the person knows he is diabetic.
Since there are no symptoms of the earliest stages of diabetic retinopathy, to make sure it is not developing, diabetics should be checked for it at least once a year. [12] The tests done can tell you if you have developed any signs of diabetic retinopathy and can let you take preventive measures before you lose any vision.
Diabetic eye screenings are done with a special camera that can take pictures of the retina that can be later looked at for signs of damage. At a typical exam, you will be given an eye chart exam first, where you read letters from a chart. After that, drops will be placed in your eyes so the camera can better see the retina.
The drops will sit in your eyes for around fifteen minutes, and then you will be asked to look at the special camera. You will see a bright flash of light as the pictures are taken. [13]
You may continue to have blurred vision for several hours after the test is done. Because of this, you need to have someone drive you to and back from the exam. [14]
FAQ
How often should I check my eyes with diabetes?
For most people with diabetes, yearly eye exams are enough. However, if you have begun to show changes from diabetic retinopathy, you may need eye exams as frequently as every three months. [15]
What to do if an ophthalmologist tells me I have diabetes?
If an opthalmologist tells you you may have diabetes, it is usually because they have seen the bulging in the retinal blood vessels, which is an early sign of diabetic retinopathy. You should make an appointment with your doctor to have your blood sugar levels looked at and to get other tests that may identify diabetes.
Do Specsavers do diabetic eye tests?
Specsavers does do diabetic eye tests, among the other types of eye tests they conduct. These tests can be arranged the same way as any other eye test. [16]
Final Thoughts
Diabetes can affect almost any part of the body, including the eyes. Many eye problems caused by diabetes do not show any symptoms until those problems are quite advanced.
When eye problems like diabetic retinopathy are advanced enough to show symptoms, it is too late to reverse any damage that has been caused.
The best way to catch eye problems before they start is to have an annual eye exam where the retina is photographed to look for signs of damage in the blood vessels.
References
- Singh, A. (2022, November 7). Blood Vessels. Diabetes UK. https://www.diabetes.co.uk/body/blood-vessels.html
- Cai, Cindy. (n.d.). Diabetes and Your Eyes: What You Need to Know. Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes-and-your-eyes-what-you-need-to-know
- diabetes UK. (2017). Diabetes and Eye Problems (diabetic retinopathy). Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/complications/retinopathy
- NHS website. (2021, December 17). Diabetic retinopathy. nhs.uk. https://www.nhs.uk/conditions/diabetic-retinopathy/
- Diabetic retinopathy – Stages. (2017, October 23). Nhs.uk. https://www.nhs.uk/conditions/diabetic-retinopathy/stages/
- nidirect. (2021, November 11). Diabetic retinopathy. Nidirect. https://www.nidirect.gov.uk/conditions/diabetic-retinopathy
- Diabetic retinopathy – Stages. (2017, October 23). Nhs.uk. https://www.nhs.uk/conditions/diabetic-retinopathy/stages/
- CDC. (2021, May 7). Diabetes and Vision Loss. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html
- Diabetes UK. (2017). Diabetic eye screening. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/diabetic-eye-screening
- Diabetic retinopathy – Stages. (2017, October 23). Nhs.uk. https://www.nhs.uk/conditions/diabetic-retinopathy/stages/
- National Institute of Diabetes and Digestive and Kidney Diseases. (2019, March 25). Diabetic Eye Disease | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease
- NHS. (2017, October 18). Diabetic eye screening. Nhs.uk. https://www.nhs.uk/conditions/diabetic-eye-screening/
- russ. (n.d.). What Is a Diabetic Eye Exam? Optometrists.org. https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/guide-to-diabetes-and-the-eyes/what-is-a-diabetic-eye-exam/
- Diabetes UK. (2017). Diabetic eye screening. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/diabetic-eye-screening
- Take Charge of Your Diabetes: Healthy Eyes | Diabetes | CDC. (2021, February 5). Www.cdc.gov. https://www.cdc.gov/diabetes/library/factsheets/diabetes-and-healthy-eyes.html
- Diabetic Retinopathy and Screening | Specsavers UK. (2011). Specsavers.co.uk. https://www.specsavers.co.uk/eye-health/diabetic-retinopathy
