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An Expert Explains the Devastating Effects of Diabetes on Vision

Barbara L. Horn, O.D.

President, American Optometric Association

Diabetes can take a devastating toll on the eyes, which is why regular eye exams are crucial to managing the disease, and also why some patients are diagnosed with diabetes by their optometrists.

Every day in my exam room, I see people who have been touched by diabetes. Whether newly diagnosed, having managed the disease for several years, or living with a loved one struggling to fight its devastating effects, the disease touches everyone.

Both in South Carolina where I practice and across the country, a high number of the patients who come into the optometrist’s office have diabetes. Many of these patients come in with no previous diagnosis of diabetes, just complaining of a sudden change in their vision. In fact, in 2018, doctors of optometry diagnosed more than 301,000 cases of diabetic retinopathy in patients who did not even know they had diabetes. Far too often, many of these patients haven’t seen their primary care physician in a while, sometimes years.

Other patients do know they have diabetes, but they have not followed up with a health care provider and have not managed their condition with appropriate medication, exercise, and diet.

The eye is the only place within the body that blood vessels can be directly viewed without having to look through skin or tissue. So, a doctor of optometry is able to detect a number of diseases that affect blood vessels, including diabetes, which damages the blood vessels in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy, one of the leading causes of blindness in the United States.

Symptoms of diabetic retinopathy include: seeing spots or floaters, blurred vision, having a dark or empty spot in the center of your vision, and difficulty seeing well at night.

Patients with diabetes who can better control their blood sugar levels will slow the onset and progression of diabetic retinopathy. Often the early stages of diabetic retinopathy have no visual symptoms. That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive eye examination once a year.

If you have diabetes, the good news is that you can help prevent or slow the development of diabetic retinopathy by taking your prescribed medication, sticking to your diet, exercising regularly, controlling high blood pressure, and getting regular eye exams.

Early detection and treatment can save your vision.

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