Edit: If you’re reading this in 2020, thank you! Many of our past blogs are recirculated from time to time, and can contain content written in a pre-COVID world. For this reason, some information may not follow new guidelines related to COVID-19, so please keep that in mind. Enjoy the article!

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

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.

Illustration showing healthy eye and eye effected by diabetic retinopathy — Illustration of healthy eye vs. eye impacted by diabetic retinopathy

Diabetic retinopathy can be broken down into two main stages: nonproliferative and proliferative.

Nonproliferative

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.”

Proliferative

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:

“A complication of diabetes caused by fluid accumulation in the macula, or central portion of the eye, that causes the macula to swell.

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:

Cataracts

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:

Illustration featuring healthy eye, and eye impacted by cataract — Illustration of healthy eye lens vs. eye with cloudy lens.

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

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:

Healthy eye depiction vs. eye effected by glaucoma — Illustration of healthy eye, and eye with 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.”

Angle-closure glaucoma

“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:

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.