Eyes and diabetes Q&A

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April 15, 2024

In this article, optometrist Dr Lisa Bakker and Scene member Charlene chat about eyes and diabetes! If you need extra help, we’re here for you. Simply self enroll for medication support, you can also call us at (410) 348-1905 or send us an email. Learn about your eyes in the Q&A video below!

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1. When I got my first exam they told me some of my blood vessels had been strained and the optometrist could actually see where there had been some seepage, what does that mean?

Diabetes can damage on your eyes in a way you might not notice at first. Sometimes, the tiny blood vessels in the back of your eyes start to leak. This leakage can cause small bleeds or a bit of protein to escape, which doesn't show up until it's already begun to harm your eyes.

Catching this early is key because you can then keep a closer eye on your blood sugar to prevent more damage. If you let it go on for too long without noticing, fixing the problem gets much tougher. How well you control your blood sugar and what you eat plays a big role in this leakage. Some people with diabetes think they can eat anything and just adjust their medicine or insulin to keep their blood sugar looking okay, but this still doesn't stop the leak. Eating right and staying active are crucial, no matter what kind of diabetes treatment you're on, to help keep those vessels from leaking.

2. How would I know if I didn't get an eye check? Are there any physical symptoms besides worse eyesight that I would let me know that I'm having an issue with my eyes?

The big issue is, without regular eye exams, you just won't know if there's a problem. I always explain to my patients that there are four stages of diabetic eye disease, or diabetic retinopathy. Stage one is the early warning. This is when tiny blood vessels in your eyes start to bleed a little or leak. If you catch this early, you can stay in stage one for a very long time without it harming your eyes.

But, if you ignore it, things get worse. In stage two, the leaking and bleeding get more serious. By stage three, the eye tries to fix itself by making new blood vessels, but this actually makes things worse because these new vessels can mess with your vision and are hard to stabilize. There are treatments like laser therapy to stop these new, harmful vessels from causing more trouble, aiming to prevent reaching stages three and four. Stage four is the worst and something we try to avoid at all costs. It's really tough on the person going through it.

3. By stage four, what are the symptoms? Is there a little to no vision? 

In stage four, seeing clearly becomes very hard. You might only see bits and pieces, like small spots of clear vision. I always say this is a place we never want to get to. But remember, you have a say in this by taking care of yourself. Keeping your blood sugar steady and sticking to your treatments without missing them is very important.

We check on people with diabetes every year, using special drops to make your pupils big. This lets us see all around the inside of your eyes to check for any leaking vessels. For some, especially if they're in stage two or if it's hard for them to keep up with their health routine, I see them every six months. It's important to know that diabetes can harm the back part of your eyes. So, even with glasses, if this part is damaged, your sight might get worse.

4. Sometimes my eyes are dry and there's mucus. Is that because of diabetes or does that naturally happen?

It can be both. Diabetes might make your eyes dry. Think of it like an oyster that makes a pearl when sand gets inside because the sand is irritating. When your eyes get dry, they produce mucus to feel less irritated. If you notice your eyes are dry, using artificial tears before bedtime and right when you wake up can help a lot. These artificial tears are made to work just like your real tears do, so they're all quite similar. Even a less expensive brand can do a good job.

5. It can take me a few minutes in the morning for my eyes to focus, is that normal? I also have trouble with bright lights.

Yes, when we age we bright lights can affect us more and we can find it takes longer to adjust in the morning. It gets tougher because this is related to metabolism, which is how quickly our bodies can process and recover from things, including how the back of the eye recovers from bright lights, like car headlights. With diabetes, this metabolism process in the eyes can be slower, making the effects of aging feel more noticeable. However, this slower eye metabolism doesn't mean there's a problem with the back of your eyes.

The content on this site is not and should not be considered medical advice or a substitute for individual medical advice, diagnosis, or treatment. You should always talk to your health care provider(s) for diagnosis and treatment, including information regarding which drugs, therapy, or other treatment may be appropriate for you. Learn more here.

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