The Effects of Diabetes on the Eye & Vision

Posted November 23, 2014


November is Diabetes Awareness Month. We asked Dr. Scott Mann to share how the eye is effected by diabetes and what we can all do to manage our risk for diabetes.


Do you know someone that has been diagnosed with diabetes? It is becoming increasingly common in the US population, so much so that most of us have a friend or family member with diabetes. To see the growing importance of this topic here are some recent statistics from the American Optometric Association and the CDC.

  • In 1990, 6.6 million people were diagnosed with diabetes
  • In 2000, 12 million people were diagnosed with diabetes
  • In 2014, 29 million were diagnosed with diabetes

Over 80% of Type 1 diabetes patients have some form of diabetic eye changes, which is called retinopathy by eye doctors.  Of those patients diagnosed with type 2 diabetes, 40% experience some eye changes.

At Invision we see a number of patients, on a daily basis, who battle this condition. Some have their diabetes well controlled and others do not. Over the years, through education and experience, we have learned tips on diabetes care. It is important to understand how diabetes can affect the eye and vision. The two primary ways are prescription shift and diabetic retinopathy.

Prescription Shift – Large changes in blood sugar, either up or down, an cause a temporary shift in the actual eyeglass or contact lens prescription. It can be tricky to diagnose because there is often a delay between these 2 events. That delay, or lag time, can be up to 2 weeks! Similarly when the blood sugar levels return to normal the prescription will revert back as well. This can be difficult to manage because many of our patients tell us something as simple as a cold will send their blood sugar levels skyrocketing. Treatment is achieved by managing blood glucose. As the blood sugar levels become stable over time the prescription will also become stable.

Diabetic Retinopathy –  In simple terms the blood vessels inside the eye can become “leaky”. These tiny blood vessels line the retina, which is the “seeing” part of the eye. The retina can swell due to leakage and cause

Diabetic Retinopathyblurred vision and a host of other complications. When this occurs we work closely with local retinal specialists to treat and manage the problems that result.


Prevention is Key

As with most medical conditions prevention of diabetes is more desirable than having to treat a patient with diabetes. Annual eye exams with pupil dilation are the most thorough method used to examine the retina for leakage. Digital retinal images are helpful both as a baseline and to track changes over time. We also make sure to discuss The ABCs of Diabetic Care with our patients at Invision.

  • A: Know your A1C!
  • B: Blood Pressure
  • C: Cholesterol
  • s: Smoking

The American Diabetes Association describes A1C in the following way: “The A1C test gives you a picture of your average blood glucose (blood sugar) control for the past 2 to 3 months. The results give you a good idea of how well your diabetes treatment plan is working.”

In some ways, the A1C test is like a baseball player’s season batting average; it tells you about a person’s overall success over a long period of time—a track record of sorts. Just as a single game’s batting record cannot give you a big picture perspective, neither can a single day’s blood test results. The A1C test provides excellent perspective. It can confirm self-testing results or blood test results by the doctor. Additionally, patients and physicians can use A1C results to judge whether a treatment plan is working. The results of the A1C test can also show you how healthy choices can make a difference in diabetes control.

These basic factors, or ABCs of diabetic care, contribute to most diabetic related complications. This applies not only to eye complications but also other complications such as those related to fingers and toes (tingling, numbness) and other body systems, including the kidneys. If you understand your A1C, control your blood pressure and cholesterol and do not smoke you can lower your risk of diabetes. Also, weight control has a dramatic effect on these other risk factors. There are other risk factors diabetes that we simply cannot control, such as age and ethnicity. However, it makes sense to manage your risk in the many ways that are within your span of control.

Make sure to stay educated about diabetes and aware of how you are working to avoid risk factors for this disease. Here are other links Invision recommends for our patients who would like more detailed information on this important topic:

American Diabetes Association

American Optometric Association Info on Diabetic Retinopathy

Mayo Clinic Info on A1C and Blood Glucose Monitoring

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