The longer you have had diabetes, the greater your risk for visual complications from the disease. Nearly everyone who has type 1 diabetes, and the majority of those with type 2 diabetes, will experience some degree of retinopathy in their lifetime. The good news is that early diagnosis and treatment with laser surgery can prevent serious vision loss in the majority of cases.
According to the ADA, diabetic retinopathy is the primary cause of new-onset blindness for adults between ages 20 and 74. The condition is caused by blockage and/or leaking of the blood vessels that feed the retina of the eye. Swelling of the macula, part of the retina, is called macular edema, and is a possible complication that can cause blurred vision. Often, symptoms of retinopathy are not noticed until they reach an advanced, or proliferative, stage.
If you have diabetes, you are at higher risk for a transient ischemic attack (TIA, or ministroke). A TIA is characterized by symptoms of stroke, but it resolves on its own without treatment. If you think you've had a TIA, call your doctor immediately. It's a warning sign that you are at risk for a full-blown stroke.
Laser treatment is usually recommended for treating advanced diabetic retinopathy. Depending on the progression of the disease, lasers may be used to either seal leaky blood vessels or destroy abnormal vessels completely.
A vitrectomy, a surgical procedure that replaces the vitreous fluid of the eye with a clear saline solution, may also be performed if blood vessels have hemorrhaged significantly into the vitreous. Both laser treatment and vitrectomy are outpatient procedures performed by an ophthalmologist or eye surgeon.
Glaucoma is caused by pressure buildup in the eye that can damage the optic nerve. In cases where the normal drainage patterns of the eye are blocked, the aqueous fluids of the eye build up and put pressure on the optic nerve. A loss of peripheral (side) vision is often the first sign of glaucoma. Depending on the type of glaucoma, you may also experience severe headache. The condition may be treated with special eye drops that lower the pressure level in the eyes. Laser surgery may also be recommended.
People with diabetes tend to develop cataracts at a younger age than the general population. Many people without diabetes also get cataracts, but if you have diabetes, you are twice as likely to develop the condition. Cataracts are characterized by a clouding of the lens of the eye. Symptoms include cloudy or fuzzy vision, double vision, and sensitivity to bright light.
You need a dilated-eye exam at least annually to detect diabetic eye disease early. Other essentials for eye health include kicking the smoking habit and lowering blood pressure and A1C. The DCCT found that people with uncontrolled blood glucose levels developed retinopathy four times more frequently than those who practiced tight control.
Mild cataracts may not require surgical intervention, unless vision is significantly reduced. Surgical treatment involves removing the clouded, natural lens and replacing it with a plastic lens calibrated for your vision needs. The prognosis is excellent for anyone undergoing cataract surgery, and the procedure improves vision in an estimated 95 percent of cases.
However, there are some risks for people who also have diabetic retinopathy, as lens replacement can cause a worsening of that condition. Your eye doctor can provide you with information on the risks and benefits of cataract surgery in your specific medical situation.