Diabetes and the Eyes

Diabetes Eye Exam

Why is a diabetic eye exam important?

  • Diabetes is the #1 reason for blindness in the US between the ages 20-74.

How to control Diabetes

  • Keep your blood sugar levels under tight control to keep your HbA1c level low.
  • Move – exercising for 30 minutes 5 times a week can dramatically decrease insulin resistance.
  • Control blood pressure – high blood pressure can worsen the signs and symptoms of diabetes.
  • Stop smoking – smoking increases risks associated with diabetes, so if you still haven’t quit here is one more reason to stop.
  • Even with doing your part to keep your blood sugar levels low it still may be necessary to take medications to control diabetes.

How does it diabetes affect the eyes?

When diabetes is not controlled the risks for diabetic eye disease increases. Even when it is under control there is a risk for diabetic changes in the retina and therefore yearly eye exam are necessary.

  1. Diabetic Retinopathy – Diabetes affects the small blood vessels in the body and the eye is full of small blood vessels in the retina. These small blood vessels develop microaneurysms and leak blood. New blood vessels can develop (neovascularization) and cause more bleeding and irreversible damage to the vision. Diabetic retinopathy left untreated and even sometimes with the best treatments can lead to blindness.normal20and20damaged_diabetic-retinopathy
  2. Eye Infections – Diabetes causes a lowering of the immune system and increase risks of bacterial eye infections.
  3. Dry Eyes – Most studies show that more than 50% of people with diabetes have dry eyes. Partially due to the decrease in immune response blepharitis and inflammation of the eye surface to cause reduced tear production and poor tear quality. Other reasons for dry eyes include peripheral neuropathy (corneal desensitization), insulin insufficiency, and inflammation on the eye surface.
  4. Double Vision – diabetes can affect the cranial nerves that are responsible for eye movement. More often the Abucens nerve (cranial nerve 6) is affected which prevent the eyes to look outwards causing double vision especially while look toward the side of the eye that is being affected.

How often do I need to have my eyes Checked?

  • It is Recommend to have a dilated eye exam with an eye doctor at least once a year. If there are any signs of diabetic retinopathy or other complications more frequent visits are necessary.


Optometric Recommendations for All Patients with Diabetes

By A. Paul Chous, O.D.

  1. Know your number. Glycosylated hemoglobin (A1c) is a “quality of life” number because it largely determines your risk of all diabetes complications, including eye disease and blindness. Each 10% reduction in A1c lowers the risk of retinopathy progression by 43%. Check your blood sugar two hours after your largest meal of the day––if it’s consistently above 150mg/dl, then let your optometrist and diabetes doctor know. Keep your blood pressure less than 130/80mm Hg.
  1. Watch what and how much you eat. Minimize consumption of white foods (bread, pasta, rice and potatoes) because they rapidly increase blood sugar and are linked to eye disease. Read food labels to determine portion size, carbohydrate content and calories. Eat more slowly. Eat a variety of brightly colored fruits and vegetables, cold water fatty fish (like salmon or sardines), and increase fiber intake (Mediterranean-type diets are consistently associated with better cardiovascular health). Consider supplements that make biologic sense for diabetes and prevention of eye disease (fish oil, vitamin D, ALA, benfotiamine, lutein/zeaxanthin, pycnogenol, etc.)
  1. Move your body. Exercise (walk, cycle and/or swim) at least 30 minutes, five days a week. Even small amounts of physical activity improve insulin sensitivity. Do some modest resistance training three times per week, as increased muscle mass decreases insulin resistance. Get a pedometer and try to walk 5,000 to 10,000 steps every day. Research shows that exercise does not worsen diabetic retinopathy, but check with your optometrist and primary care physician before engaging in vigorous sports, such as kickboxing or extreme weight lifting.
  1. Build a great diabetes team. Seek out health care providers who are knowledgeable about diabetes and advocate for you. Ask your other doctors to send me a report of their findings so that we can work together to keep you healthy. Make sure you see me every year for a dilated eye examination so that if problems develop, we catch them early and can do everything possible to protect your vision.


Thanks for reading!

Don’t forget to CONTACT ME if you have any other questions or would like to set up an appointment to check your eyes.

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Eye Doc Chism.


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