If you've been diagnosed with diabetes, you're likely already aware of how it affects many aspects of your health. However, one area that may surprise you is how diabetes can influence your vision. In fact, your blood sugar levels can directly affect your spectacle prescription. That’s why it’s so important to follow your doctor’s recommendations regarding medication and be mindful of what you eat, especially avoiding high-sugar or carbohydrate-rich foods before your eye exams.
The other reason regular eye exams are critical is because the eye is the only place in the body where we can directly observe live blood vessels, nerves, and connective tissue without needing invasive procedures. This means that your eye health can give us vital clues about what's happening in the rest of your body, particularly in relation to your diabetes.
In fact, the International Diabetes Federation (IDF) estimates that the number of adults with diabetes in Africa will nearly double by 2030, from 12.1 million in 2010 to 23.9 million. This is due to urbanization, more sedentary lifestyles, obesity, and an aging population. Globally, 2.2 billion people are living with moderate to severe vision impairment, and it’s estimated that 1.1 billion of these cases could have been prevented or treated with proper care.
One of the most significant risks for anyone with diabetes is diabetic retinopathy, which is when high blood sugar levels cause damage to the blood vessels in the retina. This can lead to abnormal blood vessel growth, retinal fluid buildup, lack of oxygen in certain areas, retinal bleeds, and even retinal detachment. These changes can cause a variety of visual symptoms, including distorted central vision, blurry vision at both near and far distances, dark spots or streaks that float across your field of vision (which may look like cobwebs), and even partial loss of your visual field.
The tricky thing about diabetic retinopathy is that in its early stages, there may be no obvious symptoms. That’s why regular eye exams are so important, even if you're not noticing any changes in your vision. The earlier we catch diabetic retinopathy, the better the chances are that we can prevent it from progressing to a more serious stage.
If you have Type 1 diabetes, it’s recommended that you begin having retina exams starting at puberty. For Type 2 diabetes, we recommend an exam at the time of diagnosis, and then every year thereafter. The longer you've had diabetes, the more important these exams become. The Diabetes Control and Complications Trial (DCCT) found that among Type 1 diabetes patients, 27% of those with 5-10 years of diabetes had signs of diabetic retinopathy, while 71-90% of those with diabetes for over 10 years showed signs, and a staggering 95% of those with diabetes for 20-30 years had diabetic retinopathy.
In the case of Type 2 diabetes, studies show that 67% of patients will develop diabetic retinopathy after 10 years of having the condition. Out of those, 10% may develop more advanced forms of the condition, known as proliferative diabetic retinopathy, which is more severe and requires specialized care.
At our practice, we’re committed to offering thorough care for diabetic patients.. We use the ETDRS classification, which is the most comprehensive and widely recognized method for grading diabetic retinopathy. During your eye exam, we’ll perform a thorough retinal exam to check for any signs of diabetic retinopathy. This may include using special imaging techniques, like OCT (Optical Coherence Tomography) or fundus photography, to look for changes to the blood vessels in the retina.
We also have a range of screening platforms, in which both our team and ophthalmologists review and provide additional advice on any treatments that might be necessary.
If we detect any signs of diabetic retinopathy, we can take steps to slow or stop the progression of the condition. In some cases, we may refer you to a retinal specialist for more advanced treatments, such as laser therapy, injections, or even surgery, depending on the severity of the condition. Once the screening is complete, the results are shared with you and with your broader healthcare team to ensure coordinated care.
Remember, the earlier we detect any signs of diabetic retinopathy, the more options we have to prevent further damage to your vision. That’s why regular eye exams are so important. If you have diabetes, it’s crucial to stay on top of your eye health – and I’m here to help guide you through that process.
- IDF. Diabetes Atlas. 4th edition. International Diabetes Federation; 2009. Brussels: [Google Scholar]
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