How diabetes can affect your eyes

Clinically reviewed by: Optum National Clinical Review Team

Diabetes affects more than 37.3 million Americans, which amounts to 11.3% of the U.S. population.^[1],[2] For people with diabetes, the body cannot produce enough insulin or it can’t properly use it, leading to a buildup of blood sugar.^[3] The resulting high glucose levels can affect the tiny blood vessels in the body, damaging the eyes as well. In fact, the Centers for Disease Control and Prevention (CDC) says that diabetes is the leading cause of new cases of blindness among adults aged 18–64 years.^[4]

Diabetes can significantly affect your vision leading to various eye diseases such as:

• Diabetic retinopathy is caused by damage to the blood vessels of the retina, which is similar to the wallpaper lining the inside of your eye. Diabetes can cause the retina to leak blood or form abnormal vessels.^[5]
• Glaucoma occurs from an increased pressure inside your eye which can damage the optic nerve. If left untreated, glaucoma can lead to peripheral, or side vision loss.^[6]
• Cataract is caused by opacification or clouding of the lens of the eye. Oftentimes, patients have blurred vision, and difficulty seeing both near and far. Some report a glare or see haloes around lights.^[7]

What you can expect at a comprehensive eye exam

During an assessment, your doctor will measure your vision, test your eye pressure and examine your eyes including your retina with a “slit lamp” to detect any small abnormalities. Your doctor will administer drops to dilate your pupils, and check for fluid buildup, bleeding or abnormal blood vessels characteristic of diabetic retinopathy. (In some cases, they may also use further imaging, like Optical Coherence Tomography (OCT), fluorescein angiography or fundus photography.) Finally, your doctor will examine the eye lens for cataract and assess the optic nerve for any glaucoma-related changes.

Your vision will be blurry after the dilation process. You will also be sensitive to light until your pupils resume their original size. So, in addition to having someone drive you home, we’d recommend bringing sunglasses to lessen the glare.

Prevention

While there is no cure once you have diabetes, there are ways you can help prevent diabetic eye disease. For instance, you can take steps to manage your blood sugar, blood pressure and lipids through diet and exercise. Be sure to talk with your doctor before significantly increasing your activity level. Ask about the amounts and types of activities that may be best for you.

Your primary doctor will check your hemoglobin A1C test periodically to gauge glucose control over the previous three months. Monitoring your blood sugar levels will help you know whether your diet, exercise and medical programs are working for you. Properly managing your blood sugar can help decrease your likelihood of having complications from diabetes. Be sure to discuss with your doctor how often to have a comprehensive eye exam and other screening tests to help manage your diabetes and reduce your risk for diabetic complications.

If you have diabetes and are concerned about the health of your eyes, schedule an appointment with one of our specialized endocrinologists today.

[1]National Diabetes Statistics Report. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Last reviewed June 29, 2022. Accessed November 3, 2022.
[2] Diabetes Statistics. https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics. Last updated February 2023. Accessed April 12, 2023.
[3] What is Diabetes? https://www.cdc.gov/diabetes/basics/diabetes.html. Last reviewed April 24, 2023. Accessed May 11, 2023.
[4] Coexisting Conditions and Complications. https://www.cdc.gov/diabetes/data/statistics-report/coexisting-conditions-complications.html. Last reviewed September 30, 2022. Accessed April 12, 2023.
[5] American Academy of Ophthalmology. Diabetic Retinopathy: Causes, Symptoms, Treatment. https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy. Accessed May 6, 2021.
[6] American Academy of Ophthalmology. What Is Glaucoma? Symptoms, Causes, Diagnosis, Treatment. https://www.aao.org/eye-health/diseases/what-is-glaucoma. Accessed May 6, 2021.
[7] American Academy of Ophthalmology. What Are Cataracts? https://www.aao.org/eye-health/diseases/what-are-cataracts. Accessed May 6, 2021.