Diabetes causes problems in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneurysms and leak blood. New blood vessel growth (neovascularization) occurs. Unfortunately, these blood vessels are weak and also leak. These leaks (hemorrhages) can cause irreversible damage to the retina and permanent vision loss.
People with diabetes are more likely to get bacterial infections, including bacterial pink eye and/or eyelid styes. Diabetes affects the autoimmune system, lowering one’s resistance to infection. Keeping your A1c (marker of blood sugar levels) as low as possible and practicing good hygiene such as washing your hands frequently and avoiding touching or rubbing your eyes can help.
Anyone with type 1 or type 2 diabetes can have diabetic eye disease and not know it, as it is painless and often has no symptoms until very advanced stages. But with appropriate care you can reduce the risk of blindness and increase your chances of preserving sight.
Eye exams for people with diabetes are very thorough and may take up to 2½ hours. Part of the exam includes applying drops to dilate your pupils, so the doctor can have a good look at what is happening at the back of your eye called the retina. No portions of the exam are painful, but when you have your pupils dilated you should be prepared to wear sunglasses after the appointment as you’ll be sensitive to light.
During an eye examination, your eye doctor will look for other signs of diabetic retinopathy and diabetic eye disease. Signs of eye damage found in the retina can include swelling, deposits and evidence of bleeding or leakage of fluids from blood vessels.
For a definitive diagnosis, you may need to undergo a test called a fluorescein angiography. In this test, illuminated dye is injected into the body through your veins (IV). As your blood flows, the dye gradually appears in the retina.
Your ophthalmologist will photograph the retina and evaluate its appearance with the help of the illuminated dye. This analysis helps determine if the disease is present and how far it has progressed.
One sometimes overlooked symptom of diabetic eye disease is nerve damage (neuropathy) affecting ocular muscles that control eye movements. Symptoms can include involuntary eye movement (nystagmus) and double vision.