Diabetes is becoming an increasingly alarming problem in the US. The estimated number of people over the age of 18 with diabetes, both diagnosed and undiagnosed, is 30.2 million-or roughly 30% of the population. The effects of diabetes can be disastrous, especially on the eyes. At Southside Medical Center in Atlanta, Georgia, our vision is to set the standard in affordable, quality healthcare, including diabetic eye exams.
What Types of Diabetes Are There?
There’s more than one type of diabetes, and management of the condition depends on the type that a person has. Not every type of diabetes stems from obesity or other obesity-related factors. Sometimes diabetes is present from childhood.
Type 1 Diabetes
Known to some as juvenile diabetes, type 1 diabetes occurs when the body cannot produce insulin. When someone is type 1 diabetic, they’re insulin-dependent and must administer artificial insulin daily to compensate.
Type 2 Diabetes
Type 2 diabetes differs from type 1 diabetes in that people with type 2 diabetes don’t have an issue producing insulin. The problem is that the cells in the body don’t respond to it as well as the cells in someone without type 2 diabetes. Type 2 diabetes is the most common type of diabetes encountered by medical professionals and is strongly linked to obesity.
During pregnancy, the body can become less sensitive to insulin. It’s most often a temporary condition that doesn’t occur in all women nor during every pregnancy. Once a woman gives birth, gestational diabetes typically goes away.
How Does Diabetes Develop?
Researchers aren’t sure about the exact cause of type 1 diabetes. However, type 2 diabetes (a.k.a. insulin resistance) is much more well known. Insulin is a hormone that the body produces which allows the sugar in your blood to access the cells in your body. Sugar is necessary for your cells to create energy, and insulin resistance usually occurs after a specific cycle develops.
First, a person is, for whatever reason, unable to make enough insulin to cover all the glucose that they eat. The body tries to make extra insulin to make up for the shortfall. The pancreas is unable to keep up with the increased need for insulin, and excess sugar floats throughout the blood doing damage instead of being absorbed by cells to create energy.
Eventually, insulin becomes less effective at helping glucose enter the cells and blood sugar levels rise ever higher. This effect is known as insulin resistance, and in type 2 diabetes it takes place gradually. Due to the gradual nature of insulin resistance, doctors recommend certain lifestyle changes to either slow the advance of the disease or halt its progress altogether.
What Eye Complications Can Stem From Diabetes?
Diabetes, no matter the type, can increase your risk for many serious health problems. Luckily, with proper treatment and lifestyle changes, the onset of complications can be delayed if not avoided altogether. One of the most widely known and talked about complications that arise from diabetes are eye complications.
How Does the Eye Work?
To understand the eye disorders that can be caused by diabetes, it’s good to know how the eye works. The eye is covered by a strong outer membrane which is clear and curved. The curved part is the cornea which focuses light and helps protect the eye.
Once light passes through the cornea, it travels through the fluid-filled anterior chamber through the pupil (a hole in the iris) and then through the lens that helps with focusing. The light then passes through another fluid-filled chamber in the middle of the eyeball and hits the retina in the back of the eye.
The retina records the light images that get focused on it and converts those images to electrical signals. The electrical signals are sent to the brain via the optic nerve and the brain decodes them. The macula, part of the retina, is highly specialized for seeing detail. Blood vessels in and behind the eye supply the macula with nourishment.
The risk of developing glaucoma is higher in people with diabetes. The longer someone has diabetes, the higher their risk of developing glaucoma becomes. Age is also a factor in glaucoma risk.
Glaucoma occurs when pressure builds up in the eye and pinches the blood vessels supplying the retina and optic nerve. As time goes on, vision is gradually lost due to the damage received by the optic nerve and retina.
If you have diabetes and notice any vision issues, it’s best to get a diabetic eye exam as soon as possible. The quicker glaucoma is caught the better your outcome will look.
Cataracts are common in people with and without diabetes, but those who suffer from diabetes are more likely to develop cataracts. Cataracts in people with diabetes tend to present at a younger age and progress faster. With a cataract, a cloudy substance covers the lens and blocks light. If light cannot enter the eye, the eye cannot see.
If you suffer from mild cataracts, using sunglasses more often and getting a specialized set with glare-control can be beneficial. With more serious cataracts that greatly affect vision, a doctor may need to perform a procedure that removes the lens of the eye and replaces it with a new, artificial one.
If your doctor notices a cataract at your diabetic eye exam, he will let you know how serious it is and what your options are.
Doctors use the term diabetic retinopathy as a general term for all disorders of the retina caused by diabetes, and there are two major types: nonproliferative and proliferative.
Nonproliferative retinopathy is the most common form. It has three stages and usually begins with capillaries in the back of the eye ballooning and forming pouches. As more blood vessels become blocked, nonproliferative retinopathy can move through the stages of mild, moderate, and severe.
Sometimes, nonproliferative retinopathy progresses to the more serious version: proliferative retinopathy. In this type, the blood vessels get so damaged that they eventually close off and new blood vessels start to grow as a response. These new vessels are weak and can leak blood, which blocks vision. They can also cause scar tissue to grow. When the scar tissue shrinks, it can distort the retina or even pull it out of place (retinal detachment).
How Retinopathy Is Treated
If a doctor diagnoses you with retinopathy at your diabetic eye exam, all is not lost! Tremendous strides have been made in the treatment of diabetic retinopathy. These treatments can prevent blindness in most people, but as always, the earlier diabetic retinopathy is diagnosed, the better your chances will be.
7 Signs It’s Time for a Diabetic Eye Exam
Testing your eyesight is important and helps track changes in your vision. Having regular eye exams is an extremely important part of obtaining an early diagnosis of eye conditions. If you have diabetes and you notice any of the following, it may be time for a diabetic eye exam.
1. Your Night Vision Has Changed
How clearly can you see other cars on the road when you drive? What about street signs? Often times, the first hint that something is wrong with your vision is when your night vision begins to get worse. Common symptoms include seeing halos around lights and difficulty distinguishing objects at night.
2. Discharge or Infection
An eye exam isn’t only useful to identify changes in vision. They also allow your medical provider to assess the overall health of your eyes and the surrounding area. Sometimes discharge means infection, and some infections clear up on their own. Often times, though, they not only require medical attention but can be contagious, too. Itchiness, redness, and/or discharge are all possible signs of issues with the eyes.
3. Frequent Headaches
Headaches can result from many causes, including muscle tension, stress, and inflammation. They can also occur when there’s a change in your vision. If you notice you’re experiencing headaches or migraines more frequently than you did before, it may be time for a diabetic eye exam.
4. Vision Disruptions
Vision disruptions include phenomena such as auras, black spots, or “floaters” that seem to move across your eyes and can indicate a serious eye issue. If things like this appear suddenly, whether accompanied by a headache or not, you may want to seek immediate medical attention from an eye doctor. Sometimes disruptions like these stem from serious conditions like retinal holes or retinal detachment.
5. Chronic Eye Fatigue
Eye strain is nothing new, and it’s commonly experienced by people from all walks of life. It often occurs from spending too much time in front of a computer screen or reading text that’s too small. However, if your discomfort doesn’t dissipate relatively soon after resting your eyes, or if it persists for 3 or more days, you may have something more serious going on than simple eye fatigue.
6. Light Sensitivity
Infections, corneal abrasions, and some disorders like meningitis can cause your vision to be more sensitive to light than usual. If you notice a sudden sensitivity to light that doesn’t go away after a short period of time, or if it comes back intermittently, you should speak with a medical professional.
7. Difficulty Focusing
Much like eye strain, difficulty focusing can stem from similar causes including small print or computer screens. However, if you find that you’re having difficulty focusing on a specific object in your field of vision, or if there’s any blurriness when you attempt to focus on a single object, it may signify a bigger problem.
Some people with difficulty focusing find that it only happens in certain levels of light. Other times the problem seems to “skip” from one eye to the other. Difficulty focusing, even if it happens only occasionally, is something that should be looked into at a diabetic eye exam to rule out any serious conditions.
When Is the Best Time to Schedule a Diabetic Eye Exam?
Schedule a diabetic eye exam as soon as you notice vision problems. If you’ve been diagnosed with diabetes or prediabetes, the wisest move is to schedule an eye exam regularly so as to catch anything before it becomes a problem. Vision issues can be hard to detect due to the fact that eye strain is something that’s commonly experienced by many people regardless of their health status.
Diabetes is increasingly common, though great strides have been made both in preventive care and in the treatment of diabetes. If you think you may be experiencing complications due to diabetes, or if you’d like to schedule an appointment to learn more about what you can do to protect your sight, call us at Southside Medical Center in Atlanta, GA.