Diabetes is commonly thought of as “that sugar disease.” Although diabetes does have something
to do with sugar, the condition has many more serious problems associated with it in addition
to not being able to freely eat candy bars. It can cause heart disease, kidney failure, amputations,
and blindness. Of course, being an eye doctor, the focus of my care is on this last complication of the
All people with diabetes, including people on oral medication as well as the insulin dependent diabetics,
need to have a dilated eye exam at least once a year . Dilation means using eyedrops to enlarge the pupils
so that we can see more of the inside of the eyes to check for signs of the disease. It does not seem to
be commonly known, but the leading cause of blindness in American adults is diabetes. Diabetes not only
affect eyes in one way, but by three entirely different processes. Diabetic retinopathy is damage to the
blood vessels of the retina (the retina is the light sensitive layer in the back of the eye). This condition
causes the blood vessels inside the eye to swell and leak fluid. Additionally, sometimes new blood vessels
form, but they are abnormal and also leak fluid. Of course the real problem here is that much of this can
be going on without any symptoms of vision changes or pain. The central sharp vision can be unaffected
while blood vessels are leaking in other parts of the eye. Cataracts, which are a clouding of the eye’s
lens, also form as a result of diabetes. Glaucoma which is an increase in fluid pressure inside the eye
that leads to optic nerve damage and a loss of vision can also be caused by diabetes.
Through a comprehensive dilated eye examination these conditions can be readily identified. If diabetic
retinopathy is present, there is a laser surgery that can be used to shrink the abnormal blood vessels.
This procedure has been proven to reduce the risk of severe vision loss from diabetic retinopathy by ninety
percent. Diabetics are twice as likely to get a cataract. The clouded lens will impair vision, however, this
clouded lens can be treated with a surgical procedure. Also, people with diabetes are almost twice as likely
to develop glaucoma. Glaucoma when promptly diagnosed can be treated with medications or surgery.
Diabetic retinopathy, cataracts, and glaucoma are not the only the things that are being tested at the
yearly eye examination but certainly these are amongst the most important. These things can cause
blindness if not treated but if caught in time, can be treated and blindness prevented. Of course,
yearly dilated eye exams are a bit of a nuisance but the price that may be paid for ignoring it is
The actual statistics of who gets diabetic retinopathy are rather alarming. Just about half of all
the people with diabetes will develop some degree of diabetic retinopathy in their lifetime. The
longer someone is a diabetic, the more likely they will develop the eye complications. Since the
eye problems are not necessarily noticed by the person with diabetes, there are recommended protocols
so that these problems can be identified and treated promptly. Many national organizations have come
together to establish the best way to treat diabetes and vision loss. The American Diabetes Association,
The National Eye Institute, The National Institutes of Health, and The Public Health Service are a few of
the organizations that have joined in this common venture.
November is National Diabetes Month. If you or someone you know is a diabetic, please take the time to
think about how devastating would be the impact of blindness. With timely diagnosis of the problems,
there are treatments available to preserve the precious gift of sight. How long has it been since your
eyes have been examined?