Eye complications

People with diabetes have a higher risk of blindness but generally it is nothing more than minor eye disorders.

To understand what happens in eye disorders, it is useful to understand how the eye works. The eye is a ball covered with a tough outer membrane. The covering in front is clear and curved. This curved area is the cornea, which focuses light while protecting the eye.

After light passes through the cornea, it travels through a space called the anterior chamber (which is filled with a protective fluid called the aqueous humor), through the pupil (which is a hole in the iris, the colored part of the eye), and then through a lens that performs more focusing. Finally, light passes through another fluid-filled chamber in the center of the eye (the vitreous) and strikes the back of the eye, the retina.

Like the film in a camera, the retina records the images focused on it. But unlike film, the retina also converts those images into electrical signals, which the brain receives and decodes.

One part of the retina is specialized for seeing fine detail. This tiny area of extra-sharp vision is called the macula.

Blood vessels in and behind the retina nourish the macula. The smallest of these blood vessels are the capillaries.

Glaucoma
People with diabetes are 40% more likely to suffer from glaucoma than people without diabetes. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age.

Glaucoma occurs when pressure builds up in the eye. In most cases, the pressure causes drainage of the aqueous humor to slow down so that it builds up in the anterior chamber. The pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is gradually lost because the retina and nerve are damaged.

Cataracts
Many people without diabetes get cataracts, but people with diabetes are 60% more likely to develop this eye condition. People with diabetes also tend to get cataracts at a younger age and have them progress faster. With cataracts, the eye's clear lens clouds, blocking light.

To help deal with mild cataracts, you may need to wear sunglasses more often and use glare-control lenses in your glasses. For cataracts that interfere greatly with vision, doctors usually remove the lens of the eye. Sometimes the patient gets a new transplanted lens. In people with diabetes, retinopathy can get worse after removal of the lens, and glaucoma may start to develop.

Retinopathy
Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy:

Nonproliferative retinopathy is the common, mild form. It usually has no effect on vision and needs no treatment. In nonproliferative retinopathy, capillaries balloon and form pouches. Although retinopathy does not usually cause any vision loss at this stage, the capillary walls may lose their ability to control the passage of substances between the blood and the retina. As a result, the retina becomes swollen and fatty deposits form within it. If this swelling affects the center of the retina, the problem is called macular edema and vision loss can result.
Proliferative retinopathy is where in some people, retinopathy progresses after several years to a more serious form. In this form, the blood vessels are so damaged they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision, which is a condition called vitreous hemorrhage. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place -- this is called retinal detachment.

Your retina can be badly damaged before you notice any change in vision. Most people with nonproliferative retinopathy have no symptoms. Even with proliferative retinopathy, the more dangerous form, people sometimes have no symptoms until it is too late to treat them. For this reason, you should have your eyes examined regularly by an eye care professional.

Several factors influence whether you get retinopathy. These include your blood sugar control, your blood pressure levels, how long you have had diabetes, and your genes.

The longer you've had diabetes, the more likely you are to have retinopathy. Almost everyone with type 1 diabetes will eventually have nonproliferative retinopathy. And most people with type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is far less common.

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The above information is provided for general educational purposes only. It is not intended to replace competent health care advice received from a knowledgeable healthcare professional. You are urged to seek healthcare advice for the treatment of any illness or disease.
Health Canada and the FDA (USA) have not evaluated these statements. This product is not intended to diagnose, treat, cure, or prevent any disease.

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