Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million. 

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.  

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring. 

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes. 

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy. 

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness. 

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages. 

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy. 

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision. 

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss. 

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids. 

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes. 

While we all know that regular eye exams can help detect warning signs of disease and prevent vision loss, many people fail to seek medical attention when there is an acute problem with the eye. In fact, only about half of Americans that are at risk for serious vision loss have been examined by an eye doctor within the last year, according to a report by the Centers for Disease Control and Prevention. 

While it’s true that some eye symptoms resolve on their own, it’s better not to take the chance when your eyesight is at risk. Here are seven eye symptoms that should be checked out by an eye doctor immediately, as they could indicate a serious underlying condition that could threaten your vision. Remember, even if you think the issue is minor, getting proper medical attention could be vital to saving your vision. 

1. Frequent Floaters

   Floaters are shadows or spots that appear to float through your field of vision, particularly when you are looking at a solid colored or bright background such as the blue sky or a white wall. They can appear in a variety of shapes such as a shower of dots or mosquito shaped for example. It is common to see floaters on occasion, however if you experience a sudden increase, especially in combination with pain, flashes or loss of peripheral vision, you should see a doctor immediately. Flashes of light may appear as a quick spark or jagged streaks of light or arcs among other shapes. This could be a sign of a very serious problem such as detached or torn retina, a hemorrhage or bleeding inside the eye, an inflammation of the vitreous or retina caused by an infection or injury or an eye tumor. In the case of a retinal detachment, the different pattern of floaters or flashes depend on how the retina tears, so if you suddenly notice a distinct pattern of floaters or light in your vision, don’t delay: seek medical attention within 24 hours. 

2. Persistent Redness or Irritation

   While minor redness can simply be a result of allergies, exhaustion or extended contact lens wear, there are some more serious causes of eye redness, especially if it persists or is accompanied by pain, swelling, discharge, vision disturbance or severe itchiness. Along with conjunctivitis (or pink eye) which can be a very contagious eye infection, redness can indicate a corneal scratch, uveitis or glaucoma. 

3. Excessive Watery Eyes 

   Whether you have a foreign object in your eye or are experiencing dryness due to allergies or environmental factors, eye watering is a natural response to keep your eyes healthy, comfortable and safe. When it is constant and disruptive, however, this is no longer normal. Excessive eye watering could indicate a chronic condition such as dry eye syndrome, tear duct problems or problems with the cornea such as a scratch or an ulcer.

4. Foreign Body in the Eye

   If you experience a foreign object in your eye, the first thing to do it try to flush it out. Never rub the eye as it could cause even greater damage. If your efforts to flush the object out are not successful it is time to see a doctor. Additionally, if you are experiencing vision disturbances, pain or redness while the object is there or after you think you have removed it, see an eye doctor immediately. 

5. Ptosis (Droopy Eyelid) 

   Ptosis or drooping eyelids is seen in one or both eyelids and can be caused by benign conditions such as allergies or merely part of the aging process. Nevertheless, it can also be a sign of a serious condition such as nerve damage, a stroke, brain tumor or a condition called myasthenia gravis, which is a neurological condition that affects the muscles of the eye. It is also sometimes a result of eye surgery or injury. Often ptosis will resolve gradually on its own, however it is something that should be checked out, especially if it occurs suddenly, to ensure there is no serious underlying cause. 

6. Bleeding Eyes 

   A subconjunctival hemorrhage in the eye is when a blood vessel right under the surface of the eye breaks. You will see that the white part or sclera of the eye has turned red. Usually, this common occurrence is nothing to be concerned about as this can happen from something as simple as straining, a sneeze or cough. In this case there is nothing to do and it will resolve on its own. If however, the redness comes after an injury to your eye or head it could indicate that there is bleeding in the brain and should be examined immediately.

7. Moderate to Severe Eye Pain 

   There are several causes of eye pain, the most serious of which is acute angle closure glaucoma or uveitis. Other causes of pain can include corneal abrasions and ulcers, scleritis, orbital cellulitis and sinusitis. 

When it comes to problems with the eye, it’s always best to err on the side of caution and get them checked out. Doing otherwise, could cost you your eyesight. Your eye doctor can help.

What’s it like to be color blind? Contrary to what the name implies, color blindness usually does not actually mean that you don’t see any color, but rather that you have difficulty perceiving or distinguishing between certain colors. This is why many prefer the term color vision deficiency or CVD to describe the condition. CVD affects men more than women, appearing in approximately 8% of men (1 in 12) and .5% of women (1 in 200) worldwide. 

Having color vision deficiency means that you perceive color in a more limited way than those with normal color vision. This ranges from mild, in which you may not even be aware that you are experiencing color differently, to severe, which is perhaps the more appropriate from to be called “color blind” and involves the inability to see certain colors. 

CVD can be inherited; it is caused by abnormalities in the genes that produce photopigments located in the cone cells in your eyes. The eyes contain different cone cells that fire in response to a specific color, blue, green or red and together allow you to see the depth and range of colors that the normal eye can see. The type of color blindness and therefore the type of color vision that is impaired, is based on which photopigments are abnormal. The most common form of CVD is red-green, followed by blue-yellow. Total color blindness or the complete inability to perceive color is quite rare. About 7% of males have congenital color blindness that they inherit from the mother’s X-chromosome. 

Color blindness can also be the result of eye damage, specifically to the optic nerve, or to the area in the brain that processes color. Sometimes an eye disease, such as cataracts, can also impact one’s ability to perceive color. Systemic diseases such as diabetes or multiple sclerosis can also cause acquired CVD. 

Living with CVD

Red-green color blindness does not mean only that you can’t tell the difference between red and green, but rather that any color that has some red or green (such as purple, orange, brown, pink, some shades of gray, etc) in it is affected. 

You many not realize all of the ways you use even subtle distinctions in color in your daily life. Here are some examples of ways that CVD can impact your life and make seemingly everyday tasks challenging:

• You may not be able to cook meat to the desired temperature based on color. 
• Most of the colors in a box of crayons will be indistinguishable.
• You may not be able to distinguish between red and green LED displays on electronic devices that indicate power on and off. 
• You may not be able to tell between a ripe and unripe fruit or vegetable such as bananas (green vs. yellow) or tomatoes (red vs green). 
• Chocolate sauce, barbecue sauce and ketchup may all look the same. 
• Bright green vegetables can look unappealing as they appear greenish, brown or grey. 
• You may not be able to distinguish color coded pie charts or graphs (which can cause difficulty in school or work). 
• Selecting an outfit that matches can be difficult. 

Knowing that one is color blind is important for some occupations that require good color discrimination such as the police officers, railway workers, pilots, electricians etc.  These are just a few of the ways that CVD can impact one’s daily life. So is there a cure? Not yet. 

While there is no cure for CVD, there is research being done into gene therapies and in the meantime there are corrective devices available including color vision glasses (such as the Enchroma brand) and color filtering contacts that for some can help to enhance color for some people. If you think you might have CVD, your optometrist can perform some tests to diagnose it or rule it out. If you have CVD, you can speak to your eye doctor about options that might be able to help you experience your world in full color.