Diabetes and Your Eyes: What You Should Know About Protecting Your Vision

By Martha Funnell, MS, RN, CDE

One of the biggest fears among people with diabetes is losing their eyesight. While it is true that diabetes is still a leading cause of blindness, it happens much less often than it did in the past. It is less common because we know more about prevention, it can be detected earlier and the treatments work better than they did before.

Four Ways Diabetes Affects Your Eyes

1. Blurred vision occurs when your blood glucose is too high, which causes the lens of the eye to swell. The blurred vision usually gets better when your blood glucose is back in the target range, but it may take as long as three months.

2. Cataracts generate a cloudy spot in the lens of the eye. The lens is made up of proteins and water and is usually clear. But if the proteins clump together, a cloudy spot forms, and light can no longer pass through. Symptoms include blurry vision, poor night vision, difficulty distinguishing colors and problems with glare. Keeping your blood glucose close to normal, wearing sunglasses when you are outside and not smoking can help prevent cataracts.

3. Glaucoma is a condition in which there is too much fluid inside the eye, leading to a buildup of pressure in the eye. If not treated, the increased pressure can damage the nerves in the eye and cause loss of vision. Glaucoma is usually treated with eye drops.

4. Retinopathy refers to damage to the retina, a structure at the back of the eyeball that sends the pictures of what we see to the brain. Damage to the retina occurs when small blood vessels in the eye are harmed by high blood glucose. The central part of the retina is called the macula. The macula is a tiny area that provides extra sharp vision.


Background retinopathy

Over time, high blood glucose and blood pressure levels cause the small blood vessels in the retina to become weak. As blood flows through the damaged vessels, small pouches balloon out where there are weak places. Because these pouches are fragile, they can break easily, causing blood to leak into the retina. Scars form over the places where the vessels break. There is usually no change in sight unless the macula is affected.

Proliferative retinopathy

The small blood vessels in the retina can become completely blocked. In an effort to keep the blood flowing, new blood vessels grow around the blocked vessels. The new blood vessels grow over the retina and into the clear jelly that fills the eyeball, called the vitreous. Because the new blood vessels are fragile, they can break and leak blood into the vitreous. You may feel as though you are looking through a spider web or through fog,see black floating spots or lose sight in one eye. If this happens, you need to get help immediately.

treAting retinopAthy

Laser therapy is used to seal or destroy the weak places in the small blood vessels that break or leak.

A vitrectomy is surgery done to remove the clear jelly that fills the eyeball and remove any blood or scar tissue. The clear jelly is replaced with clear fluid.  This surgery is only done when sight has been lost in one eye. Sometimes vision will return after the operation.

preventing dAmAge to your eyes

Most of the damage in retinopathy is caused by high levels of glucose being forced through the very tiny blood vessels in the back of the eye.  You can prevent damage or keep it from getting worse by keeping your blood glucose and blood pressure in your target range.  There usually are no early signs and symptoms of retinopathy. The only way to find out if you have any signs of retinopathy is to have your eyes dilated and examined by an eye care professional. Drops are placed in the eye to dilate the pupils so they can be seen clearly. It is not painful, but be sure to take sunglasses with you to your appointment because bright lights can be slightly painful when your pupils are dilated. This should be done once a year. Ask your doctor for a referral if you have never had an eye exam or it has been more than one year.

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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.