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Symptoms and Signs of Diabetic Eye Disease

Doctor's Notes on Diabetic Eye Disease

Diabetes is one of the leading causes of irreversible blindness worldwide. Diabetic eye disease can cause a wide range of eye problems in including a reversible, temporary blurring of the vision to severe, permanent loss of vision. Diabetic eye disease also increases the risk of developing cataracts and glaucoma. Severe diabetic eye disease develops most often in people who have had diabetes for years, and who have had poor control of their blood sugars over time.

Symptoms of diabetic eye disease include mild-to-severe blurred vision, hazy vision, glare from lights at night, and reversible or permanent vision loss. Associated symptoms, such as eye discomfort, abnormal awareness of the eyes, feeling as if something is in the eye, and eye pain or discharge may or may not occur, depending on the underlying cause of the blindness.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Diabetic Eye Disease Symptoms

  • If the person has fairly large, rapid shifts in their blood sugar levels, they may notice that their vision becomes blurry. This may occur prior to the diagnosis of diabetes mellitus, or it may develop after the initiation of treatment or a change in treatment of diabetes mellitus. This difficulty with vision or focusing will disappear once blood sugar levels have been stable for approximately one week.
  • Even if the person has background diabetic retinopathy or early proliferative diabetic retinopathy, it is possible that they may not have any symptoms, or they may experience mild-to-severe blurring or vision loss. Many people with severe diabetic eye disease may not realize that they have a vision problem until it is too late and permanent damage has already occurred.
  • If the person has a cataract, vision may become blurry or hazy. At night, the person may experience glare from oncoming lights.
  • If the person has glaucoma, they may not experience any symptoms until a significant loss of vision has already occurred.
  • In diabetic eye disease due to diabetic retinopathy, symptoms of pain or discomfort in the eyes are usually not present.

Diabetic Eye Disease Causes

Over many years, high blood sugar (hyperglycemia) and other abnormalities in metabolism found in people with diabetes may damage the blood vessels in the body. This damage to the blood vessels leads to poor circulation of the blood to various parts of the body. Since the function of the blood is to carry oxygen and other nutrients, this poor circulation causes decreased oxygen delivery to tissues in different parts of the body and subsequent damage to those tissues. Some of the most sensitive tissues to decreased blood flow and oxygen delivery include the brain, heart, kidneys, and the eyes. Lack of adequate oxygen delivery to these areas causes strokes, heart attacks, kidney failure, and vision loss.

Cataracts

Rapid shifts in blood sugar levels: Many people with diabetes may notice that their vision becomes blurry when they have fairly large, rapid shifts in their blood sugar levels. This temporary blurring is because the sugar in the blood can diffuse into the lens of the eye and cause it to swell, thus changing the focal point of the eye and resulting in blurring of the vision. Over time, repeated swelling of this type is thought to damage the lens and cause it to become cloudy, resulting in a cataract.

Glaucoma

The high blood sugar levels also may eventually damage the cells lining the trabecular meshwork toward the front of the eye, where the fluid (called aqueous humor) flows out from within the eye. When these cells are damaged, the trabecular meshwork cannot function correctly. If the trabecular meshwork does not function correctly, the fluid cannot flow out of the eye properly and the pressure inside the eye can increase. This high pressure inside the eye can damage the optic nerve and cause permanent vision loss. This process is called glaucoma.

Diabetic eye disease can cause a wide range of problems that affect the eyes, in particular the retina, the lens, and the trabecular meshwork.

Blindness is strictly defined as the state of being totally sightless in both eyes. A completely blind individual is unable to see at all. The word blindness, however, is commonly used as a relative term to signify visual impairment, or low vision, meaning that even with eyeglasses, contact lenses, medicine or surgery, a person does not see well. Diabetic eye disease can cause permanent visual loss, which may be mild or severe. Given modern treatment options, it is unusual today for diabetic eye disease to cause the total inability to see. Proliferative diabetic retinopathy and diabetic macular edema, if untreated can result in significant loss of vision.

What are the symptoms of blindness?

Blindness from diabetic eye disease is similar to blindness from other causes. All people who are blind or have visual impairment have the common symptom of difficulty seeing. People with similar levels of visual loss may have very different responses to that symptom. If one is born blind, there is much less adjustment to a non-seeing world than there is for people who lose their vision late in life, where there may be limited ability to cope with that visual loss. Support systems available to individuals and their psychological makeup will also modify the symptom of lack of sight. People who lose their vision suddenly, rather than over a period of years, also can have more difficulty adjusting to their visual loss.

Associated symptoms, such a discomfort in the eyes, awareness of the eyes, foreign body sensation, and pain in the eyes or discharge from the eyes may be present or absent, depending on the underlying cause of the blindness.

The visual loss associated with diabetic eye disease, if due to vitreous hemorrhage in proliferative diabetic retinopathy, may be sudden in onset. It may clear slowly, as the blood obstructing the vision is absorbed by the body. A person who is blind from diabetic retinopathy may have no visible signs of any abnormalities when sitting in a chair and resting. Depending on the degree of blindness, the affected individual will exhibit signs of visual loss when attempting to ambulate. Some blind people have learned to look directly at the person they are speaking with, so it is not obvious they are blind.

Blindness is strictly defined as the state of being totally sightless in both eyes. A completely blind individual is unable to see at all. The word blindness, however, is commonly used as a relative term to signify visual impairment, or low vision, meaning that even with eyeglasses, contact lenses, medicine or surgery, a person does not see well. Diabetic eye disease can cause permanent visual loss, which may be mild or severe. Given modern treatment options, it is unusual today for diabetic eye disease to cause the total inability to see. Proliferative diabetic retinopathy and diabetic macular edema, if untreated can result in significant loss of vision.

What are the symptoms of blindness?

Blindness from diabetic eye disease is similar to blindness from other causes. All people who are blind or have visual impairment have the common symptom of difficulty seeing. People with similar levels of visual loss may have very different responses to that symptom. If one is born blind, there is much less adjustment to a non-seeing world than there is for people who lose their vision late in life, where there may be limited ability to cope with that visual loss. Support systems available to individuals and their psychological makeup will also modify the symptom of lack of sight. People who lose their vision suddenly, rather than over a period of years, also can have more difficulty adjusting to their visual loss.

Associated symptoms, such a discomfort in the eyes, awareness of the eyes, foreign body sensation, and pain in the eyes or discharge from the eyes may be present or absent, depending on the underlying cause of the blindness.

The visual loss associated with diabetic eye disease, if due to vitreous hemorrhage in proliferative diabetic retinopathy, may be sudden in onset. It may clear slowly, as the blood obstructing the vision is absorbed by the body. A person who is blind from diabetic retinopathy may have no visible signs of any abnormalities when sitting in a chair and resting. Depending on the degree of blindness, the affected individual will exhibit signs of visual loss when attempting to ambulate. Some blind people have learned to look directly at the person they are speaking with, so it is not obvious they are blind.

Diabetes Management Tips and Preventing Complications Slideshow

 Diabetes Management Tips and Preventing Complications Slideshow

After your shower each day, check your body from head to toe. Look for cuts, sores, blisters, and ingrown toenails. Don't forget the places where moisture can hide and germs can grow. Check under your arms and breasts, and between your legs and toes. Look extra closely at your feet. Use a mirror to help you see all over. If you have cuts or scrapes, treat them quickly. Also, take a moment to moisturize dry skin.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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