Prevent diabetes problems. NATIONAL INSTITUTES OF HEALTH What are diabetes problems? Too much sugar in the blood for a long time causes …
Prevent diabetes problems
Keep your eyes healthy
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
Prevent diabetes problems: Keep your eyes healthy
NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
Contents
What are diabetes problems? 3 What should I do each day to stay healthy with diabetes? 4 What can I do to prevent diabetes eye problems? 5 How can diabetes hurt my eyes? 6 How can diabetes hurt the retinas of my eyes? 7 What happens as diabetes retina problems get worse? 8 What can I do about diabetes retina problems? 10 How do I know if I have retina damage from diabetes? 11 Does diabetes cause other eye problems? 12 For more information 13 More in the series 15 Acknowledgments 16
2
What are diabetes problems?
Too much sugar in the blood for a long time causes diabetes problems This high blood sugar can damage many parts of the body, such as the eyes, heart, and blood vessels Diabetes problems can be scary, but there is a lot you can do to prevent them or slow them down This booklet is about eye problems caused by diabetes You will learn the things you can do each day and during each year to stay healthy and
prevent diabetes problems
Retina Blood vessels on retina
Lens
Optic nerve Vitreous
High blood sugar can cause eye problems
3
What should I do each day to stay healthy with diabetes?
Follow the healthy eating plan that you and your doctor or dietitian have worked out Eat your meals and snacks at around the same times each day Be active a total of 30 minutes most days Ask your doctor what activities are best for you Take your diabetes medicine at the same times each day Check your blood sugar every day Each time you check your blood sugar, write the number in your record book Call your doctor if your numbers are too high or too low for 2 to 3 days Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails Brush and floss your teeth and gums every day Dont smoke 4
What can I do to prevent diabetes eye problems?
Keep your blood sugar and blood pressure as close to normal as you can Have an eye doctor examine your eyes once a year Have this exam even if your vision is OK The eye doctor will use drops to make the black part of your eyes pupils bigger This is called dilating DY-lay-ting your pupil, which allows the doctor to see your retina Finding
eye problems early and getting treatment right away will help prevent more serious problems later on
Dilated eye
Undilated eye
Ask your eye doctor to check for signs of cataracts and glaucoma See page 12 to learn more about cataracts and glaucoma If you are pregnant and have diabetes, see an eye doctor during your first three months If you are planning to get pregnant, ask your doctor if you should have an eye exam Dont smoke 5
How can diabetes hurt my eyes?
High blood sugar and high blood pressure from diabetes can hurt four parts of your eye: 1 Retina REH-ti-nuh The retina is the lining at the back of the eye The retinas job is to sense light coming into the eye 2 Vitreous VIH-tree-us The vitreous is a jellylike fluid that fills the back of the eye 3 Lens The lens is at the front of the eye and it focuses light on the retina 4 Optic nerve The optic nerve is the eyes main nerve to the brain
Retina Blood vessels on retina
Lens
Optic nerve Vitreous
This is a picture of an eye from the side
6
How can diabetes hurt the retinas of my eyes?
Retina damage happens slowly Your retinas have tiny blood vessels that are easy to damage Having high blood sugar and high blood
pressure for a long time can damage these tiny blood vessels First, these tiny blood vessels swell and weaken Some blood vessels then become clogged and do not let enough blood through At first, you might not have any loss of sight from these changes This is why you need to have a dilated eye exam once a year even if your sight seems fine One of your eyes may be damaged more than the other Or both eyes may have the same amount of damage Diabetic retinopathy REH-tih-NOP-uh-thee is the medical term for the most common diabetes eye problem
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What happens as diabetes retina problems get worse?
As diabetes retina problems get worse, new blood vessels grow These new blood vessels are weak They break easily and leak blood into the vitreous of your eye The leaking blood keeps light from reaching the retina You may see floating spots or almost total darkness Sometimes the blood will clear out by itself But you might need surgery to remove it Over the years, the swollen and weak blood vessels can form scar tissue and pull the retina away from the back of the eye If the retina becomes detached, you may see floating spots or flashing lights You may feel as if a curtain has been pulled over
part of what you are looking at A detached retina can cause loss of sight or blindness if you dont take care of it right away Call your doctor right away if you think you have a detached retina
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Blood vessels on retina Retina
Optic nerve Lens Vitreous No diabetes damage to retina Blood vessels on retina Retina Lens Vitreous Some diabetes damage to retina Blood vessels on retina Retina Optic nerve Lens Vitreous New blood vessels Optic nerve
A lot of diabetes damage to retina
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What can I do about diabetes retina problems?
First, keep your blood sugar and blood pressure as close to normal as you can Your eye doctor may suggest laser treatment, which is when a light beam is aimed into the retina of the damaged eye The beam closes off leaking blood vessels It may stop blood and fluid from leaking into the vitreous Laser treatment may slow the loss of sight If a lot of blood has leaked into your vitreous and your sight is poor, your eye doctor might suggest you have surgery called a vitrectomy vih-TREKtoh-mee A vitrectomy removes blood and fluids from the vitreous of your eye Then clean fluid is put back into the eye The surgery often makes your eyesight better
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How do I know
if I have retina damage from diabetes?
You may not get any signs of diabetes retina damage or you may get one or more signs:
Blurry or double vision Rings, flashing lights, or b 
lank spots Dark or floating spots Pain or pressure in one or both of your eyes Trouble seeing things out of the corners of your eyes
BZFED
OFCLTB
TEPOLFDZ
LPCTZDBFEO
ZOECFLDPBT
ETOLEBZEFDC
BOFCPTEBLFBEZCOPE
PTEO
B
F
C
70
60
50
40
30 20 15 10 7 4
Normal
Blurry
If you have retina damage from diabetes, you may have blurry or double vision
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Does diabetes cause other eye problems?
Yes You can get two other eye problems–cataracts and glaucoma People without diabetes can get these eye problems, too But people with diabetes get them more often and at a younger age 1 A cataract KA-ter-act is a cloud over the lens of your eye, which is usually clear The lens focuses light onto the retina A cataract makes everything you look at seem cloudy You need surgery to remove the cataract During surgery your lens is taken out and a plastic lens, like a contact lens, is put in The plastic lens stays in your eye all the time Cataract surgery helps you see clearly again 2 Glaucoma glaw-KOH-muh starts from
pressure building up in the eye Over time, this pressure damages your eyes main nerve–the optic nerve The damage first causes you to lose sight from the sides of your eyes Without treatment, you can go blind Treating glaucoma is usually simple Your eye doctor will give you special drops to use every day to lower the pressure in your eye Or your eye doctor may want you to have laser surgery
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For more information
Eye Care Professionals ophthalmologists, optometrists To find an eye doctor near you, ask your doctor for a recommendation or contact a nearby hospital or medical school Look for the American Academy of Ophthalmology on the Internet at wwweyenetorg and click on Find an Ophthalmologist Diabetes Teachers nurses, dietitians, pharmacists, and other health professionals To find a diabetes teacher near you, call the American Association of Diabetes Educators toll-free at 1800TEAMUP4 18008326874, or look on the Internet at wwwaadenetorg and click on Find an Educator
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Recognized Diabetes Education Programs teaching programs approved by the American Diabetes Association To find a program near you, call toll-free at 1800DIABETES 18003422383, or see
wwwdiabetesorg/education/edustate2asp on the Internet Dietitians To find a dietitian near you, call the American Dietetic Associations National Center for Nutrition and Dietetics toll-free at 18003661655, or look on the Internet at wwweatrightorg and click on Find a Dietitian Government The National Eye Institute NEI is part of the National Institutes of Health To learn more about eye problems, write or call NEI, 2020 Vision Place, Bethesda, MD 208923655, 301 4965248; or see wwwneinihgov on the Internet
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More in the series
The Prevent Diabetes Problems series includes seven booklets that can help you learn more about how to prevent diabetes problems
For free single copies of these booklets, call, write, fax, or email the National Diabetes Information Clearinghouse 1 Information Way Bethesda, MD 208923560 Phone: 18008608747 or 301 6543327 Fax: 301 9078906 Email: ndic@infoniddknihgov These booklets are also available under Health Information at wwwniddknihgov on the Internet 15
Acknowledgments
The National Diabetes Information Clearinghouse thanks the people who helped review or field-test this booklet
For American Association of Diabetes Educators Lynn Grieger, RD, CDE
Arlington, VT Celia Levesque, RN, CDE Montgomery, AL Teresa McMahon, PharmD, CDE Seattle, WA Barbara Schreiner, RN, MN, CDE Galveston, TX For American Diabetes Association Phyllis Barrier, MS, RD, CDE Alexandria, VA Linda Haas, PhC, RN, CDE Seattle, WA Kathleen Mahoney, MSN, RN, CDE Drexel Hill, PA Randi Kington, MS, RN, CS, CDE Hartford, CT Diabetes Research and Training Center Albert Einstein School of Medicine Norwalk Hospital Norwalk, CT Jill Ely, RN, CDE Sam Engel, MD Pam Howard, APRN, CDE Diabetes Research and Training Center Indiana University School of Medicine Indianapolis, IN Madelyn Wheeler, MS, RD, FADA, CDE Diabetes Research and Training Center VA/JDF Diabetes Research Center Vanderbilt School of Medicine Nashville, TN Ok Chon Allison, MSN, RNCS, ANP, CDE Barbara Backer, BS James W Pichert, PhD Alvin Powers, MD Melissa E Schweikhart Michael B Smith Kathleen Wolffe, RN Grady Health System Diabetes Clinic Atlanta, GA Ernestine Baker, RN, FNP, CDE Kris Ernst, RN, CDE Margaret Fowke, RD, LD Kay Mann, RN, CDE Health Care Financing Administration Baltimore, MD Jan Drass, RN, CDE Indian Health Service Albuquerque, NM Ruth Bear, RD, CDE Dorinda Bradley, RN, CDE Terry Fisher,
RN Lorraine Valdez, RN, CDE Indian Health Service Red Lake, MN Charmaine Branchaud, BSN, RN, CDE Medlantic Research Center Washington, DC Resa Levetan, MD For National Eye Institute Judith Stein Bethesda, MD Texas Diabetes Council Texas Department of Health Austin, TX Luby Garza-Abijaoude, MS, RD, LD
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National Diabetes Information Clearinghouse
1 Information Way Bethesda, MD 208923560 Phone: 18008608747 or 301 6543327 Fax: 301 9078906 Email: ndic@infoniddknihgov The National Diabetes Information Clearinghouse NDIC is a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK NIDDK is part of the National Institutes of Health under the US Department of Health and Human Services Established in 1978, the clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public NDIC answers inquiries; develops and distributes publications; and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes Publications produced by the clearinghouse are carefully reviewed for scientific accuracy, content, and readability
This
publication is not copyrighted The clearinghouse encourages users of this booklet to duplicate and distribute as many copies as desired This booklet is also available under Health Information at wwwniddknihgov on the Internet
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US DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health
National Institute of Diabetes and Digestive and Kidney Diseases NIH Publication No 004279 May 2000
