The Eye in Diabetes

Q. I have diabetes; why does my family doctor advise me to have my eyes checked at least once a year? How can diabetes affect my eyes?

A. Diabetes can have both temporary as well as permanent effects on the eyes. If the level of your blood sugars fluctuates significantly, sugar actually enters into the eye’s natural crystalline lenses and affects focusing. Your eyes will focus differently with very high blood sugar as opposed to a low one and this fluctuating vision will vary with the level of your sugars.

More importantly, diabetes can have more significant long-lasting effects on the eye. Individuals with diabetes are more prone to develop cataracts probably because of these blood sugar fluctuations. Once diagnosed, cataracts can be extremely successfully treated and vision can be restored so well with the newest generation of specialized implants that you might have excellent vision afterward without the burden of glasses! Once the cataracts are removed, fluctuating blood sugars will not affect the focusing of your eyes. The other significant effect of diabetes is diabetic retinopathy. This condition shows up early as dilated retinal blood vessels (microaneurysms) and if left untreated can expand, break, cause retinal hemorrhages and ultimately loss of vision that is difficult to restore. If, however, these are diagnosed early through a yearly exam with an ophthalmologist, these small vessels can be treated and sealed off with laser treatments, thus helping to prevent future loss of vision.