By: Kathy Hubbard
Some years ago, I met a woman whose husband had just been diagnosed with diabetes. She complained to me that now her husband was going to suffer heart disease, kidney disease, nerve damage, foot, oral, hearing, and mental health problems, as well as the worst fate, in her opinion, blindness.
Despite my encouraging comments about how people with controlled diabetes can avoid all of the risks, she was convinced that his maladies were her future. I don’t know what he actually did contract, but I do know that he developed diabetic retinopathy.
“Diabetic retinopathy is a diabetes complication that affects eyes,” Mayo Clinic explains. “It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy might cause no symptoms or only mild vision problems. But it can lead to blindness.
“The condition can develop in anyone who has type 1 or type 2 diabetes. The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop this eye complication.”
What Mayo didn’t say, the National Eye Institute says, is that women with gestational diabetes are also at high risk for getting diabetic retinopathy. They suggest that women have an eye exam as soon as they are diagnosed with gestational diabetes.
The American Academy of Ophthalmology explains two stages of diabetic eye disease. The first is NPDR, or non-proliferative diabetic retinopathy.
“With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision,” AAO says.
What also happens is that the blood vessels in the retina close off (macular ischemia). That means that blood can’t reach the macula. Tiny particles (exudates) may form in the retina, causing blurry vision.
“PDR (proliferative diabetic retinopathy) is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision,” AAO explains.
These new blood vessels can form scar tissue, which can then cause problems with the macula or even lead to a detached retina. PDR is serious. It can affect both central and peripheral vision.
You’ll want to make an appointment with your eye care provider immediately if you suspect either NPDR or PDR, particularly if you’re seeing an increasing number of floaters, having blurry vision, or vision that sometimes is blurry and sometimes clears up, seeing blank or dark areas in your field of vision, having poor night vision, noticing colors appear faded or washed out, or that you just can’t see.
But even if you don’t suspect one of these conditions, if you have diabetes, you should see an eye care professional once a year. Even though diabetic retinopathy is the most common cause of vision loss for people with diabetes, the disease can cause other conditions as well.
NEI says that “having diabetes makes you two to five times more likely to develop cataracts. It also makes you more likely to get them at a younger age. And having diabetes nearly doubles your risk of developing a type of glaucoma called open-angle glaucoma.”
You don’t need me to nag you about controlling your diabetes, but I will. Take your medicines as directed. If you have questions, call your primary care provider. Stick to your diet. If you find it difficult, get an appointment with a registered dietician and talk honestly about what’s keeping you from eating healthily.
Exercise. Yes, I said exercise. Walk around the block. Park at the far end of the parking lot everywhere you go. Take the stairs. And do it every day. Control your high blood pressure and cholesterol. And always follow your PCP’s instructions to the letter.
“Controlling your blood sugar and blood pressure can stop vision loss,” AAO says. “Sometimes, good sugar control can even bring some of your vision back.”
Bonner General Ophthalmology Clinic can be reached at 208-265-1011.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee on May 15, 2024.
