Diabetes is one of the leading causes of blindness in the United States. It is estimated that more than 14 million Americans have some form of diabetes. Public health officials expect that by 2050, there will be more than 48 million diagnosed cases in the United States.
Diabetes is caused when the pancreas either does not produce enough insulin or is unable to process insulin correctly. The disease poses numerous complications for the eyes, including fluctuations with eyeglass or contact lens prescriptions; cataracts at a younger age; increased risk of developing glaucoma; and diabetic retinopathy, which is the most serious risk.
The retina is the wall-like structure that lines the back of the eye; it is made up of light-sensitive tissue and a network of blood vessels. In cases of diabetes, the blood vessels of the retina can begin to leak fluid, blood, or cholesterol deposits on the retina. It is also possible that abnormal blood vessels will form and can cause serious bleeding and scarring of the retina.
Diabetic retinopathy frequently has no accompanying symptoms until it is advanced, at which point it is more difficult to treat.
The effects of diabetic retinopathy vary by case, but some common symptoms include blurred vision and a sudden, temporary loss of sight. In late stages of the disease, abnormal vessel growth can lead to retinal detachment and glaucoma.
The longer a person lives with diabetes, the greater their risk of developing diabetic retinopathy. After five years with diabetes, a person’s risk of development is around 20 percent; after 15 years, the risk increases to about 80 percent. Diabetic retinopathy is the leading cause of blindness among people aged 20 to 64 in the U.S.
Studies have shown that those who have good control over their diabetes and carefully monitor their glucose levels have a decreased risk of developing sight-threatening complications. In addition, it is important to treat high blood pressure. Also, those who smoke are more likely to have high blood pressure and higher blood sugar levels, which makes diabetes more difficult to control. Not smoking and maintaining good glucose and blood pressure levels can reduce one’s risk of diabetes-related vision problems.
Diabetic retinopathy is generally treated with laser beams that both seal the leaky blood vessels and prevent more from developing. Laser treatment is often successful at maintaining vision if the retinopathy is found early, but it is not capable of restoring vision that is already lost.
Although diabetic retinopathy is the most serious vision impairment, blurred vision and cataracts can also affect diabetics. Blurred vision can be an early symptom of diabetes and can also occur when the disease is not being well controlled. In the case of cataracts, the lens of the eye becomes cloudy causing vision to be blurred or dimmed. It generally afflicts people as they age, but can affect younger individuals who have diabetes. Treatment involves removal of the clouded lens and replacement with a specialized inert plastic lens called an intraocular lens.
Most sight loss from diabetes is preventable. It is crucial for diabetics to have their eyes checked annually, even if they are not experiencing any vision problems.