April 18, 2024 Eye damage (diabetic retinopathy)

Many people living with diabetes have some form of eye damage or "diabetic retinopathy". Diabetic retinopathy can lead to vision changes or blindness.

With blood glucose (sugar) control, regular eye exams and early treatment, the risk or worsening of eye damage can be reduced.

How diabetes affects the eyes

Having too much sugar in your blood can damage the blood vessels in the part of the eye called the retina. The retina is the tissue lining the back of the eye.

High sugar levels cause the blood vessels to swell and leak into the retina and cause blurred vision or blind spots. If left untreated, new blood vessels may grow and cause further damage to your vision.

Regular eye exams are important

All people with diabetes (both type 1 and type 2) are at risk for diabetic retinopathy. Diabetic retinopathy develops over time and often goes unnoticed until vision loss occurs.

Following your diabetes ABCDEs and getting your eyes checked regularly by an ophthalmologist or optometrist are crucial to prevent vision loss or keep it from getting worse.

If you have diabetic retinopathy, very effective treatments are available. Your eye-care specialist will explain these to you.

When to get an eye exam

You should get an eye exam once a year, unless your ophthalmologist or optometrist has suggested something different. The risk of vision loss can be greatly reduced with regular checks. Remember, you may not be aware of changes to your vision and many problems can be treated when caught early.

If you notice any of the following changes to your vision, go see an eye doctor immediately:

• blurred vision
• flashes of light in the field of vision
• sudden loss of vision
• blotches or spots in vision

Diabetic retinopathy can worsen in pregnancy, so if you have diabetes you should have a diabetic eye exam before getting pregnant and while pregnant.

About the eye exam

During the eye exam, your eye-care provider uses a special magnifying instrument to look for any blood vessel damage at the back of your eye. Eye exams are a safe and necessary part of your diabetes management.

Contact your eye-care professional directly for an appointment or have your health-care provider refer you for an eye exam.

A diabetic eye exam may be covered by your provincial health plan at no cost to you. You can confirm this with your diabetes care provider or when making an appointment.

Reducing your risk of diabetic retinopathy

To prevent retinopathy or prevent it from getting worse, keep your blood sugar, blood pressure, and blood cholesterol within a healthy range.

Follow the ABCDEs of staying healthy with diabetes to reduce the risk of eye damage.

A – A1C – Most people should aim for an A1C of 7%* or less by managing blood sugars well. A1C is a blood test that is a measure of your average blood sugar level over the past 120 days.

B – Blood pressure – Control your blood pressure to less than 130/80* mmHg.

C – Cholesterol – The LDL (bad) cholesterol target is less than 2.0* mmol/L.

D – Drugs to protect your heart – Speak with your health-care team about medications.

E – Exercise & Eating – Regular physical activity, healthy eating, and maintain a healthy body weight.

S – Screening for complications – Ask your health-care team about tests for your heart, feet, kidneys, and eyes.

S – Smoking cessation – Stop smoking and seek support for help with quitting.

S – Self management, stress, and other barriers – Set goals for yourself to reach the targets and live well with diabetes, such as managing stress effectively.

* Discuss your target values with your health-care team. Note that A1C targets for pregnant women, older adults and children 12 years of age and under are different

For more information about diabetic retinopathy, visit the Canadian National Institute for the Blind (CNIB).

To find a CAO optometrist in your area, visit the Canadian Association of Optometrists.