Diabetes is a complex condition that has many less familiar side effects than the body’s inability to produce insulin (type 1) or the body’s inability to respond to insulin or produce enough (type 2). One of the most significant health risks of diabetes outside diabetic comas caused by too high or too low blood sugar is the damage done to large blood vessels that are inside your heart, brain, and legs, and damage done to small blood vessels in the feet, nerves, kidneys, and eyes. Patients with diabetes need to see optometrists who understand the complex issues diabetes can cause on eye health regularly, at least every year because there are differences between a standard eye exam and an eye exam for someone who has diabetes.
What are some eye problems that can affect people with diabetes?
People who have diabetes are more susceptible than the general population to both glaucoma, blurry vision, and cataracts. Glaucoma is the build-up of pressure inside of the eyeball, and it can lead to loss of sight over time. There are many treatments for glaucoma, including medication, eye drops, traditional surgery, or laser surgery. Glaucoma can be treated very successfully, but once you begin to lose vision because of glaucoma, that vision loss is irreversible, which is why it is so essential for people with diabetes to get regular eye exams so that if they develop glaucoma, it can be caught in the early stage before vision loss occurs.
A cataract is the clouding of the eye’s natural lens. Cataracts usually only affect people over the age of 40, but for those with diabetes, they can have symptoms as early as 20. This is due to high levels of blood sugar. While cataract surgery is possible for patients with diabetes, it is more complicated, and there may be limitations in their vision.
If your vision starts to blur and you have diabetes, it may not be a cause for new glasses. It could be caused by high blood sugar. To correct this, you need to get your sugars under control and keep them there for upwards of three months to have your vision return to normal.
The retina is the group of cells that exist at the back of your eyes. They are what take in light and turn it into an image to send to your brain. If you have diabetes, particularly high blood sugar, the small blood vessels in your retina can become damaged which can lead to blindness. It can be treated early on, but the best treatment is prevention, keeping blood sugar levels low.
What are the differences between an eye exam for someone with diabetes and someone without?
If you have diabetes, then your optometrist will perform all standard aspects of an eye exam as well as what is called a dilated retinal exam. You will have to use eye drops that will dilate your pupils so that the eye doctor can see into the back of your eye. These can sting, and you may experience a metallic taste in your mouth. They can also take a photograph of your retina so that they can have a comparable timeline of your eye health year to year. They will also do a glaucoma exam, which includes testing the inner eye pressure (tonometry), the shape and colour of the option nerve (the dilated eye exam), a visual field test, the angle where the iris meets the cornea, and the thickness of the cornea. Cataracts can be visually detected.