Diabetic Eye Conditionscauses, symptoms and treatments

Text size:
Last updated 9/25/2023
Dr. Assil discusses how diabetes affects the eye.

Diabetic Eye Problems

Diabetes can cause progressive damage within your eyes, resulting in poor vision, ‌severe vision loss, or even blindness. They generally present without warning signs because there usually are no symptoms in their early stages.

 

Fortunately, annual dilated vision exams as part of your regular eye exams can detect problems early, providing an opportunity for timely intervention and treatment, which can help prevent or minimize vision loss. 

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.

 

Schedule your consultation today with the internationally recognized doctors at Assil Gaur Eye Institute

 

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.

 

 

Diabetic eye conditions FAQS

How do doctors diagnose diabetic eye problems? 

Signs of diabetic retinopathy and DME are detected through a painless comprehensive diabetic eye exam performed by your eye doctor. This includes:

 

  • Visual Acuity Testing: This test measures your ability to see at various distances.
  • Tonometry: This test measures the pressure inside of your eye.
  • Dilated eye exam: after placing eye drops in your eyes to widen the pupil, your doctor looks closely at your retina, macula, and optic nerve to look for leaky blood vessels, swelling, or damage to your lens or nerve tissue.
  • Optical Coherence Tomography: This test uses a special computer that captures light waves to get detailed images of your retina.

 

If your doctor finds evidence of DME or severe diabetic retinopathy, a fluorescein angiogram might be recommended to look for leaking blood vessels. This simple test involves injecting fluorescent dye into your arm vein and taking pictures of the blood vessels as the dye reaches your eye. 

Can proliferative retinopathy be cured?

While there is no cure for proliferative retinopathy, there are treatments available that can help manage the condition and prevent further vision loss. The treatment’s primary goal is to reduce abnormal blood vessel growth in the retina.

 

Some treatments available for proliferative retinopathy include laser surgery photocoagulation, which uses a laser to seal off leaking blood vessels, and injections of medications that can help prevent the growth of new blood vessels.

What causes diabetic retinopathy? 

Diabetic retinopathy is caused by damage to blood vessels in the retina, which is part of the eye that senses light and sends images to the brain. High blood sugar levels (hyperglycemia) are characteristic of diabetes. In addition to causing vision problems, kidney damage is another typical result of elevated blood sugar levels.

What are the four stages of diabetic retinopathy? 

The four stages of diabetic retinopathy are:

 

  • Mild nonproliferative diabetic retinopathy: In this stage, small areas of swelling called microaneurysms appear in the retina’s blood vessels.
  • Moderate nonproliferative diabetic retinopathy: In addition to microaneurysms, some of the blood vessels in the retina become blocked.
  • Severe nonproliferative diabetic retinopathy: Many more blood vessels become blocked, which can form new blood vessels in the retina.
  • Proliferative diabetic retinopathy: In this advanced stage, new blood vessels grow on the retina’s surface and into the vitreous gel, the clear substance that fills the eye. These new blood vessels are fragile and can bleed, leading to vision loss or blindness.

Can diabetic retinopathy be reversed with diet? 

While diet can play a role in managing diabetes, it is not typically sufficient to reverse diabetic retinopathy once it has developed. Diabetic retinopathy is caused by damage to the blood vessels in the retina, which can result from high blood sugar levels over a long period. 

 

The best way to prevent and manage diabetic retinopathy is to maintain reasonable blood sugar control through a combination of healthy eating, exercise, and medication prescribed by a healthcare provider.

 

 

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 

Diabetic eye condition articles from our blog

2145 Total 1st Party Reviews
4.9 out of 5 Stars
  • Google
    Professional staff as well as elegant waiting rooms, with all safety protocols in place during these challenging times.
    Kenneth J.
  • Google
    My family and I have been going to Santa Monica for about 10 years and have always been treated with the most respect. They tru...
    Jennifer B.
  • GatherUp
    The office staff were courteous and friendly. The doctor was very informative and thorough. I really appreciate how kind the do...
    Catherine F.
  • GatherUp
    Best Doctor ever
    Afsaneh A.
  • GatherUp
    This is a wonderful experience every time I have come and the great care and professionalism is appreciated
    Maria D.
  • GatherUp
    You guys are fantastic. Always take good care of me.
    Joseph T.
  • GatherUp
    Great service
    Emma C.
  • GatherUp
    Dr. Sodhi Gaur and all staff continue to extend their warm concern and care for my needs.
    Sharyn A.
  • GatherUp
    I am very pleased.
    Aida Y.
  • GatherUp
    Dr. Assil is a skilled and innovative surgeon who is also a compassion and warm person. Personally, I think he is a genius who ...
    Stephanie B.
  • Google
    I had Lasik done way back in 1998. Dr. Assil and his staff were antastic back then and continue to give exceptional service tod...
    John F.
  • GatherUp
    Excellent and hospitable staff!
    Dimitri S.
Look Who Trusts Their Eyes to Assil Gaur Eye Institute...
  • LeBron James

    Los Angeles Lakers

    LeBron James is one of the NBA's greatest of all time. He absolutely depends on his vision to perform at the very highest level. That's why he's an AGEI LASIK surgery patient.

  • Anthony Davis

    Los Angeles Lakers
  • Chris Paul

    Phoenix Suns
  • Paul George

    Los Angeles Clippers
  • Marlee Matlin

    Actress
  • Michelle Williams

    Actress
  • Dwyane Wade

    Miami Heat (retired)
  • LaToya Jackson

    Entertainer
  • Lorenzo Lamas

    Actor
  • Philip Bailey

    Earth Wind and Fire
  • Gary Sinise

    Actor
  • Rip Hamilton

    Former NBA player
  • John Salley

    Commentator, former NBA player
  • Blair Underwood

    Actor
  • Tom Arnold
    Comedian/Actor
  • Troy Evans
    Actor
  • John Noble
    Actor
  • Isaac Eddy
    Actor/Director/Teacher
  • Barbara Rush
    Actress
  • John Emerson
    US Ambassador to Germany
  • Shane Mosley
    Former professional boxer
  • Cuttino Mobley
    Former NBA player
  • Seth Gordon
    Director
  • Maurice Evans
    Former NBA player
  • Wang Luoyong
    Actor
  • Jesse Metcalfe
    Actor
  • Ananda Lewis
    Television Personality
  • Rob Brydon
    Comedian
  • Clifton Collins Jr.
    Actor
  • Malinda Williams
    Actress
  • Adrienne Frantz
    Actress
  • Brad Pitt
    Actor
  • LeBron James
    Los Angeles Lakers
  • Anthony Davis
    Los Angeles Lakers
  • Chris Paul
    Phoenix Suns
  • Courtney Cox
    Actress
  • Paul George
    Los Angeles Clippers
  • Marlee Matlin
    Actress
  • Michelle Williams
    Actress
  • Dwyane Wade
    Miami Heat (retired)
  • Jalen Brunson
    Dallas Mavericks
  • Mychal Thompson
    Commentator, former NBA player
  • LaToya Jackson
    Entertainer
  • Lorenzo Lamas
    Actor
  • Philip Bailey
    Earth Wind and Fire
  • Gary Sinise
    Actor
  • Rip Hamilton
    Former NBA player
  • John Salley
    Commentator, former NBA player
  • Blair Underwood
    Actor
  • Tom Arnold
    Comedian/Actor
  • Troy Evans
    Actor
  • John Noble
    Actor
  • Isaac Eddy
    Actor/Director/Teacher
  • Barbara Rush
    Actress
  • Rudy Garciduenas
    Blue Man Group
  • John Emerson
    US Ambassador to Germany
  • Shane Mosley
    Former professional boxer
  • Cuttino Mobley
    Former NBA player
  • Seth Gordon
    Director
  • Maurice Evans
    Former NBA player
  • Cheri Blauwet
    Physician and Wheelchair Racer
  • Wang Luoyong
    Actor
  • Jesse Metcalfe
    Actor
  • Jeana Wilson
    Actress
  • Courtnee Draper
    Actress
  • Ananda Lewis
    Television Personality
  • Robyn Johnson
    Producer
  • Rob Brydon
    Comedian
  • Cary Schuman
    Actor
  • Roland Buddy Lewis Jr.
    Comedian
  • Clifton Collins Jr.
    Actor
  • Malinda Williams
    Actress
  • Chad Jeffers
    Musician
  • Adrienne Frantz
    Actress
  • Franco Carlotto
    Body Builder
  • Brad Mates
    Musician
  • David Pichette
    Musician
  • Mike Melacon
    Professional Baseball Player
  • Nautica de la Cruz
    Radio Personality
  • Lynn Conkwright
    Body Builder
  • Nely Galan
    Producer
  • Roxanne Galla
    Actress