Diabetes statistics can be scary. According to 2015 data from the American Diabetes Association, one American in ten has the condition – one in four over 65. And it’s the seventh leading cause of death. It creates specific eye problems, such as diabetic retinopathy and diabetic macular edema. But there’s good news, too: Adults with Type 2 diabetes may reverse eye damage, if they catch it quickly.
Types Of Diabetes
Diabetes comes in three forms: Type 1, Type 2 and gestational. The latter affects a small percentage of pregnant women and stops when they give birth, though it makes them likelier to get Type 2 later.
Type 1, formerly called juvenile diabetes, can happen at any age. The body can’t make insulin, the hormone that takes glucose (blood sugar) to cells that turn it into energy. In Type 2, the most common form, blood sugar rises to dangerously high levels. The pancreas makes more insulin to compensate but can’t keep up.
Clues point to Type 1: Excessive thirst and drinking, constant need to eat, frequent bathroom use, fatigue, terrible breath. Physicians detect it in general exams, often in childhood, and treat it quickly.
Type 2 usually begins later in life and proceeds silently, which makes an annual dilated eye exam crucial. Your eye doctor may be the first person to identify diabetes, especially if you don’t have regular medical checkups. And diabetic retinopathy, the most common problem, can be reversed with diet, weight loss and exercise in its early stages.
Diabetic retinopathy occurs when glucose damages blood vessels in the retina. Those can swell and leak or close to prevent blood from flowing through. Sometimes abnormal blood vessels grow on your retina. The disease begins in a non-proliferative form, which has few symptoms.
You’ve passed into the proliferative stage. In this phase, you notice blurriness or a sudden increase in the size or number of floaters in your field of vision. Diabetics’ vision may grow foggy after a big meal, then clear up as blood sugar drops. One eye often responds differently from the other.
Treatment (Including For Diabetic Macular Edema)
Even then, doctors can treat proliferative retinopathy with injections, if changes in diet and exercise don’t help. If left too long, however, the disease can’t be reversed. Diabetic retinopathy remains the leading cause of blindness in working-age adults.
Diabetic macular edema occurs when leaking blood vessels cause fluid buildup in the macula, the part of the retina that controls our most detailed vision abilities. It takes two forms, focal DME (abnormalities in blood vessels) or diffuse DME (widening or swelling of retinal capillaries). Treatments include injections, anti-inflammatory steroids and surgery to remove blood from the vitreous, the gel that fills the area between the lens and the retina.
Diabetics need to be especially cautious about changes in vision. Adults with diabetes are two to five times likelier to develop cataracts, a clouding of the lens, and at younger ages. They’re twice as likely to get glaucoma, a group of diseases that affect the optic nerve linking the eye to the brain. Because diabetics become more susceptible to infections (especially eye infections) and are slower to heal, contact lenses create problems if owners don’t clean them carefully.
Diabetics do get one more piece of good news. However, medical insurance covers their eye exams, so they don’t need vision insurance to get annual checkups.