Goals/Objectives: To focus on your diabetic eye health by regular retinopathy screening and vision evaluation.
Time Frame:

    • Diabetic retinal screening (annually or bi-annually)
    • Vision exam (bi-annually)

Fluctuating blood sugars are known to cause fluctuating vision. There is a correlation between the change in blood sugar levels and the ability of the crystalline lens in your eye to maintain a sharp focus. High blood sugar weakens the blood vessels in your eyes. Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.

When you were a child, “going to the eye doctor” probably meant going to an optometrist, a doctor who can test and evaluate your vision and prescribe glasses or contact lenses, if needed.

You can then take your prescription to an optician who specializes in providing eyewear that meets your optometrist’s prescription, can fit you with the eyewear, and can adjust the eyewear to your needs.

An ophthalmologist is a doctor who specializes in diseases of the eyes and can perform surgeries, if needed, and treat other serious eye problems.

    • See an optometrist if you need a vision exam and evaluation, need to update your prescription, or are unsure about the status of your eye health.
    • Visit an ophthalmologist if you suspect you have a serious eye condition or may need surgery.
    • Go to an optician to purchase glasses and contact lenses or to get your glasses adjusted.

Diabetic Retinopathy

Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and the leading cause of blindness for all adults in the United States.

People with type 2 diabetes should have a diabetic retinal screening as soon as diabetes is diagnosed and then every year after that. If your diabetic retinal screening  results are normal, your doctor may consider follow-up exams less often.

My optometrist/ophthalmologist told me that diabetics should have a diabetic retinal screening every year. But my Primary Care Physician said I should have the screening every other year as long as my retinal screening is normal.

There are many factors that have been linked to the cause of retinopathy, including diet soda and sedentary behavior.

One source claims you can cut your risk of diabetic retinopathy in half when you keep your A1C below 6%. We recommend keeping your A1C below 5.7%.

Macular Edema

When fluid seeps into your retina, it can cause diabetic macular edema. The leaking makes your retina swell, which hampers the work of your macula, the special, sensitive part that gives you sharp vision. If you catch it early, there’s a chance you can stop long-term damage.

Cataracts

Cataracts are when the clear lens of your eye becomes cloudy, like you’re trying to see through a fog. Aging is the most common cause of cataracts. You can help prevent or delay cataracts by shielding your eyes from bright lights by wearing sunglasses. Or you can get an anti-UV (ultraviolet) coating on your prescription glasses.

Glaucoma

Diabetes is associated with a significantly increased risk of glaucoma. Glaucoma is a progressive optic disease that is mainly caused by high pressure in the eyes and is characterized by gradual death of retinal ganglion cells (RGC). This eye disease, which is a leading cause of irreversible blindness worldwide, has generated a major public health problem. Primary open angle glaucoma (POAG) is the most common type of glaucoma in diabetic individuals, with nearly 70 million affected worldwide.

Blindness

Blindness, of course, is the end stage of diabetic eye diseases. You are not likely to go blind if you keep your blood sugar under control (ideally, an A1C of 4.0-5.6%).

References

Boyd, Kierstan; reviewed by Kendra Denise DeAngelis; edited by David Turbert. “What Are Cataracts?” American Academy of Ophthalmology (October 1, 2019). https://www.aao.org/eye-health/diseases/what-are-cataracts (accessed on 7/23/2020).

Bressler, Neil M., M.D., a professor of ophthalmology. “Many People With Diabetes Still Lose Vision, Despite Availability of Vision-Sparing Treatment,” Johns Hopkins Medicine (December 19, 2013). https://www.hopkinsmedicine.org/news/media/releases/many_people_with_diabetes_still_lose_vision_despite_availability_of_vision_sparing_treatment (accessed on 7/23/2020).

“Eye conditions related to Diabetes,” ©2014-2020 Royal National Institute of Blind People. https://www.rnib.org.uk/eye-health/eye-conditions/diabetes-related-eye-conditions (accessed on 7/23/2020).
Website includes two short videos of case studies.

Fennell, Diane. “Sedentary Behavior Linked to Diabetic Retinopathy,” Diabetes Self-management (August 12, 2016). https://www.diabetesselfmanagement.com/blog/sedentary-behavior-linked-diabetic-retinopathy/ (accessed on 7/23/2020).

Groch, Judith, MedPage Today Senior Writer. “Dietary Carbohydrates Linked to Cataract Formation,” MedPage Today (June 7, 2006). https://www.medpagetoday.com/primarycare/dietnutrition/3488 (accessed on 7/23/2020).

Hackethal, Veronica, MD. “Diet Soda Linked to Increased Risk for Diabetic Retinopathy,” Medscape (December 31, 2018). https://www.medscape.com/viewarticle/907086?src=soc_fb_190105_mscpedt_news_mdscp_dietsoda&faf=1 (accessed on 7/23/2020).

Mendosa, David, Patient Advocate. “How You Can Cut Your Risk of Diabetic Retinopathy,” Health Central (June 27, 2016). https://www.healthcentral.com/article/how-you-can-cut-your-risk-of-diabetic-retinopathy (accessed on 7/23/2020).

Mendosa, David, Patient Advocate. “The Eye Exam That Can Save Your Sight,” Health Central (November 9, 2016). https://www.healthcentral.com/article/the-eye-exam-that-can-save-your-sight (accessed on 7/23/2020).
Early detection and treatment can reduce the risk of blindness by 95 percent. Diabetic retinopathy can lead to blindness if you don’t get it treated on time.

WebMD Medical Reference; reviewed by Alan Kozarsky, MD. “Diabetic Macular Edema (DME),” WebMD (March 14, 2019). https://www.webmd.com/diabetes/diabetic-macular-edema#1 (accessed on 7/23/2020).

WebMD Medical Reference; reviewed by Michael Dansinger, MD. “What Is Diabetic Retinopathy?”
WebMD (June 22, 2019). https://www.webmd.com/diabetes/diabetic-retinopathy#1 (accessed on 7/23/2020).

“What Is Diabetes-related Eye Disease?” Prevent Blindness, n.d. https://preventblindness.org/diabetes-and-your-eyes/ (accessed on 7/23/2020).

Zenni Optical. “Optometrist vs. Ophthalmologist vs. Optician — What’s the Difference?” Zenni Blog (August 29, 2017). https://www.zennioptical.com/blog/optometrist-vs-ophthalmologist-vs-optician/ (accessed on 7/23/2020).

Zhao, Ying-Xi and Xiang-Wu Chen. “Diabetes and risk of glaucoma: systematic review and a Meta-analysis of prospective cohort studies,” International Journal of Ophthalmology. 2017; 10(9): 1430–1435. Published online 2017 Sep 18. doi: 10.18240/ijo.2017.09.16.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596230/ (accessed on 7/23/2020).