By David Benderson, M.D., Ophthalmologist, Valley Medical Group, Ridgewood, NJ

Newswise — Loss of vision is one of the many dreaded complications of diabetes. Over 5.3 million Americans suffer from diabetes-related retinal disease or diabetic retinopathy. After 20 years of living with diabetes, nearly all type 1 diabetics will have some degree of diabetic retinopathy, as will approximately 60 percent of type 2 diabetics. Some of these patients will experience significant vision loss.

If you think of the eye as a camera, the retina is the film. This important structure translates images into electrical signals, which are then sent to your brain for processing. High blood sugar levels associated with diabetes damage small blood vessels throughout the body, including the retina. Advanced diabetic retinopathy can cause a devastating form of glaucoma due to growth of unhealthy blood vessels on the iris (neovascular glaucoma). Elevated blood sugar can also result in swelling of the lens, which can temporarily change a patient’s glasses prescription, resulting in blurry vision. Once the blood sugar is controlled, the lens swelling resolves. Additionally, diabetics are at a higher risk for developing cataracts, or permanent clouding of the lens.

A multi-pronged approach is necessary to prevent and treat diabetic eye disease. To begin with, it is essential that diabetics work closely with their primary care physician and, in many cases, endocrinologist, to keep their blood sugar under good control. Other health care providers, such as nurse educators and nutritionists serve an essential role in diabetes management. Large studies have shown that tight control of blood sugar reduces the risk of diabetic complications, including retinopathy.

Furthermore, diabetics should undergo a complete eye examination, including dilation (in order to view the retina and other structures) on a yearly basis. If a diabetic patient develops diabetic retinopathy, more frequent examination may be necessary. If macular edema or proliferative diabetic retinopathy develop, early diagnosis and treatment is essential to preserving vision. Conversely, if a diabetic patient waits until they have vision loss to visit the doctor, treatment may be less effective.

Ultimately, prevention is the best tool to combat diabetic eye disease. Effective control of blood sugar and blood pressure, maintaining a healthy and balanced lifestyle, and regular follow-up with a primary care physician and ophthalmologist are key elements in avoiding vision loss from diabetes.

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