You might not think a lot about your eyes. We often take being able to see for granted. Hopefully, you’ll never have a problem with your vision. But, if you have diabetes, you need to be extra careful to make sure that your eyes stay as healthy as possible.

What is diabetic retinopathy?

All people with diabetes (both type 1 and type 2) are at risk for a serious eye disease called diabetic retinopathy. This is the leading cause of blindness in adults. Nearly half of all people with diabetes have retinopathy, and the longer you live with diabetes, the more likely you are to develop it. It occurs when blood vessels in the retina (the light-sensitive tissue at the back of the eye) are damaged. Sometimes these blood vessels swell and leak fluid. Or new, fragile blood vessels can form on the retina and these can break and bleed.

Retinopathy can lead to vision loss in two ways:

• Proliferative retinopathy: This is when blood vessels leak into the retina, leading to blurry vision and, sometimes, total vision loss.
• Macular edema: This is when blood vessels leak into the macula, the part of the eye that gives you sharp, straight-ahead vision.

You may not have any symptoms of retinopathy early in the disease. But as retinopathy advances, you may notice that your vision is blurry and/or you may see spots or “floaters” in your vision. Left untreated, retinopathy may progress to the point of severe vision loss and even blindness.

How do I know if I have diabetic retinopathy?

One of the most important things you can do to preserve your vision and prevent vision loss is to get a dilated eye exam every year. This is not the same kind of eye exam that you might get at an eyeglass store in the mall. With a dilated eye exam, your eye doctor will place drops in your eyes to dilate (widen) your pupils. This allows him or her to better see inside your eye, including your retina, to look for any signs of blood vessel damage or leakage.

Your eye doctor can also check your optic nerve and other parts of your eye to make sure they’re all healthy. After the dilated eye exam, your vision may be a little blurry and you may be sensitive to light.? This is normal. You might have to wear sunglasses, and it’s a good idea for someone else to drive you home.

How is diabetic retinopathy treated?

In its more advanced stages, it is treated with laser surgery. Macular edema is treated with either laser surgery, or with injections of a medicine into your eye. If you have severe vision loss, you might need a procedure called a vitrectomy. These treatments sound scary, but they can be very effective. The key is to catch any problems as soon as possible, before you start to lose your vision.

How can I prevent vision problems?

It’s very important to keep up with your yearly dilated eye exams. But it’s also important to keep your diabetes under control, to the best of your ability. That means aiming to keep your blood glucose level and A1C levels within target range. In addition, aim to keep you blood pressure at a safe level (usually less than 140/80). Ask your doctor about your own glucose, A1C and blood pressure goals. If your levels are not ideal right now, find out what you can do to get them where they need to be.

For information about other diabetes complications, have a look at Preventing Diabetes Complications.