Diabetic Eye Conditions: causes, symptoms and treatments

How does diabetes affect the eye?

When your body cannot produce or use insulin properly, blood glucose (sugar) can build up in your blood and damage your blood vessels and nerves. Over time, elevated blood sugar levels can cause the blood vessels in the retina (the back of your eye) to weaken and develop tiny bulges or leaks. 

These changes increase your risk factors for numerous eye conditions, including diabetic retinopathy, macular edema, cataracts, and glaucoma.

What is diabetic retinopathy?

This disease affects about 30 percent of diabetics. In advanced diabetes, the damaged retinal blood vessels close off, causing the retina to create new but abnormally weak and ‌tiny blood vessels to grow on the retina, the light-sensitive tissue at the back of the eye. The best chance of minimizing its damage is to begin treating it during the early stages of diabetic retinopathy.

What is diabetic macular edema (DME)? 

Diabetic macular edema is a complication of diabetes that affects the macula, the central part of the retina responsible for sharp vision. It occurs when fluid accumulates in the macula, causing swelling and distortion of central vision. DME is the most common cause of vision loss among people with diabetic retinopathy.

What is diabetic glaucoma?

Having diabetes doubles your chances of developing glaucoma, including a rare condition known as neovascular glaucoma. This involves the growth of abnormal new blood vessels on the iris (the colored part of your eye), which block the normal outflow of intraocular fluid, raising eye pressure.

Learn more about glaucoma here.

What are diabetic cataracts? 

High glucose levels can cause deposits to build up on your natural lens, causing clouding. People with diabetes are two to five times more likely to develop cataracts than those without diabetes. Diabetics also develop cataracts at an earlier age than non-diabetics.

Learn more about cataracts here.

Who is at risk for diabetic retinopathy?  

Numerous factors can influence whether you get retinopathy, such as:

• Blood sugar control
• High blood pressure
• ‌High cholesterol
• How long you’ve had diabetes
• Genetics
• Hispanics, African Americans, and Native Americans are at greater risk of developing diabetic retinopathy.

The longer you've had diabetes, the more likely you are to have retinopathy. Almost everyone with type 1 diabetes will eventually have non-proliferative retinopathy. And most people with type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is less common.

People who keep their blood sugar levels closer to normal are less likely to have retinopathy or milder forms.

What are the symptoms of diabetic retinopathy and other diabetic eye conditions? 

The biggest challenge in managing diabetic eye disease is there are no "early warning" symptoms. During the early stages, you do not experience any pain or vision changes. Only when it is too late and the damage to your eyes progresses, will you even know something is wrong!

When the disease has progressed, you may begin experiencing one or more of these symptoms:

• Frequent changes in your vision from sharp to blurry
• Blurry or wavy vision
• Poor color vision
• Areas of darkness or black holes in your vision
• Tiny spots or fine dark strings (known as Floaters)
• Flashes of light

If you experience a sudden onset of any of the above symptoms, contact your eye doctor.

Are there non-surgical treatment options for diabetic eye conditions? 

Advanced diabetic eye conditions can be treated with medicine, laser treatments, surgery, or a combination.

Anti-VEGF medications for diabetic eye conditions 

Anti-VEGF medications block a protein responsible for the growth of abnormal blood vessels and stop vessels from leaking.

They are essential in treating diabetic macular edema to prevent further vision loss and may even improve vision in some cases.

Laser treatment for diabetic eye conditions 

This laser treatment, known as Photocoagulation, cauterizes leaky blood vessels to keep them from leaking and causing swelling.

What surgical treatments are there for diabetic eye conditions?

Some advanced diabetic eye conditions require surgical intervention. The most common surgeries performed for diabetic eye conditions include:

Vitrectomy 

Diabetic retinopathy causes the growth of new leaky blood vessels, which can lead to severe bleeding (vitreous hemorrhage) and scar tissue formation within your eye. Scar tissue can cause the delicate retina tissue to detach from the inner wall of your eye.

In such cases, a surgical procedure called a vitrectomy may be necessary to remove blood and scar tissue from the vitreous gel and repair the retinal detachment. 

Learn more about vitrectomies here.

Cataract Lens Replacement 

Cataract surgery is a same-day procedure performed in our surgery center. It involves removing your cloudy natural lens due to a cataract and replacing it with a clear artificial lens. Your vision following this surgery will depend on the new lens and the degree of existing diabetic retinopathy and macular edema.

Learn more about cataract lens options.

Can you lower your risk of diabetic eye disease?

Yes! Preventing diabetic eye conditions involves managing diabetes effectively. This includes controlling blood sugar levels through a balanced diet, regular exercise, and prescribed medications or insulin. 

Maintaining healthy blood pressure and cholesterol levels, not smoking, and attending annual comprehensive eye exams are essential for early detection and timely treatment of potential eye complications.

Assil Gaur Eye Institute makes a world of difference for their diabetic patients 

Our diabetic eye care is among the best diabetic eye care available in the nation. This continues to motivate us to strive for the highest standards of excellence anywhere.

This is one of the reasons that Los Angeles Magazine named Assil Gaur Eye Institute as one of the Top ophthalmology doctors in Los Angeles, year after year. 

Our nationally recognized ophthalmologists and eye institutes are leaders in a wide range of ophthalmological conditions, including state-of-the-art LASIK vision correction, retinal treatments, cataract surgery, glaucoma care, macular disease, and, of course, diabetic eye conditions, to name just a few.

The AGEI diabetic care team includes Stanford-trained retina specialist Dr. Svetlana Pilyugina (or “Dr. P,” as she is known to her patients). As a member of an elite group of only 3,000 retina-vitreous specialists in the United States, Dr. Pilyugina brings to AGEI over a decade of clinical experience and a unique skill set in the medical and surgical treatment of retinal diseases. She is also a member of the American Academy of Ophthalmology.

The Assil Gaur Eye Institute clinics are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Los Angeles, Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

Resources:

Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy - PMC

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537579/ 

Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study - PMC

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27454/ 

Global prevalence and major risk factors of diabetic retinopathy - PubMed

http://www.ncbi.nlm.nih.gov/pubmed/22301125 

Diabetic Retinopathy | National Eye Institute

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

Injections to Treat Eye Conditions | National Eye Institute

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy/injections-treat-diabetic-retinopathy-and-diabetic-macular-edema 

Diabetic Retinopathy: Causes, Symptoms, Treatment - American Academy of Ophthalmology 

https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy 

Diabetes and Vision Loss | CDC

https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html 

Eye Complications | American Diabetes Association

https://www.diabetes.org/diabetes/complications/eye-complications 

What is Retinopathy? | American Diabetes Association https://www.diabetes.org/diabetes/eye-health/understand-eye-conditions/what-is-retinopathy