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November is Diabetic Eye Disease Awareness Month! This month, founded in 1998, aims to draw awareness to both diabetic eye disease and diabetes.
But, what exactly is diabetic eye disease?
According to the National Institutes of Health (more specifically, the NIDDK), diabetic eye disease is “a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.”
Let’s take a closer look at each of the above ailments.
All medical content reviewed by our Drug Safety Associate Patience Biesiot, RN, BSN.
Diabetic retinopathy is when increased blood sugar levels damage a retina’s blood vessels. The impacted blood vessels can “swell, and leak… or they can close, stopping blood from passing through.”
This condition can develop in those effected by type 1 or type 2 diabetes, and is one of the leading causes of blindness in diabetic individuals.
Diabetic retinopathy can be broken down into two main stages: nonproliferative and proliferative.
According to Prevent Blindness,
“The early stage of this disease is called nonproliferative diabetic retinopathy. In this stage blood vessels swell and sometimes bulge or balloon (aneurysm). The vessels may leak fluid that can build up in the retina and cause swelling. This condition is called macular edema, and it changes the vision of individuals with the disease. The blurriness is sometimes compared to trying to look through water.”
According to Prevent Blindness,
“In many cases when the small blood vessels close down, new, unhealthy blood vessels grow. These unhealthy blood vessels are not able to feed the retina. This stage of the disease is known as proliferative diabetic retinopathy.”
Symptoms of Diabetic Retinopathy
The American Academy of Ophthalmology notes 6 symptoms that may appear as the disease worsens:
- Seeing an increasing number of floaters
- Having blurry vision
- Having vision that changes sometimes from blurry to clear
- Seeing blank or dark areas in your field of vision
- Having poor night vision
- Noticing colors appear faded or washed out losing vision
For a quick visual, consider checking out the below video:
Diabetic Macular Edema
Bausch + Lomb defines Diabetic Macular Edema as:
The macula is filled with cells that are responsible for sharp, straight ahead vision that helps with reading and driving. When the macula begins to fill with fluid and swell, the ability of those cells is impaired causing blurred vision that can be severe.”
Symptoms of Diabetic Macular Edema
Diabetic Macular Edema arises due to diabetic retinopathy.
Noted symptoms include:
- Blurry vision
- Wavy or “distorted” vision
- Changes to how colors are seen
Check out the following video for a short introduction to the condition:
While cataracts can occur for a variety of reasons, “Cataracts are two to five times more frequent in patients with diabetes than patients without diabetes”. Increased glucose levels can contribute to cataracts.
Mayo Clinic defines cataracts as “a clouding of the normally clear lens of your eye.”
All About Vision offers the following definitions of the three primary types of cataracts:
- A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
- A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with aging.
- A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
Symptoms of Cataracts
The American Academy of Ophthalmology lists 5 possible symptoms of cataracts:
- Having blurry vision
- Seeing double (when you see two images instead of one)
- Being extra sensitive to light
- Having trouble seeing well at night, or needing more light when you read
- Seeing bright colors as faded or yellow instead
The National Eye Institute created the following video as an introduction to the subject:
Glaucoma is summarized by the American Academy of Ophthalmology as: “A disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.”
AAO continues on with definitions of two major types of glaucoma:
Primary open-angle glaucoma
“This is the most common type of glaucoma. It happens gradually, where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first.”
“This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind.”
Symptoms of Glaucoma
Open-angle glaucoma typically has no early warning signs. It progresses and develops rather slow, and may slip under the radar for many years.
Acute angle-closure glaucoma however, can occur very suddenly, and bring on the following symptoms:
- Hazy or blurred vision
- The appearance of rainbow-colored circles around bright lights
- Severe eye and head pain
- Nausea or vomiting (accompanying severe eye pain)
- Sudden sight loss
Top Doctors United Kingdom created a great introductory video, which I have attached below:
The Path Ahead
Continuing forward, individuals should have a comprehensive eye exam every one or two years. For those impacted by diabetes, a dilated eye exam is recommended once per year to potentially catch early-signs of issues. With proper management of diabetes, timely eye exams, and treatments (if needed), those living with diabetes can set themselves up for a lifetime of sight.
Always visit your eye specialist if any changes to your vision occur.
More Information on Diabetes and Diabetic Eye Disease: