Living with diabetes requires a lot of medications, devices and checkups. It can be expensive. And while a lot can be done to manage it, it can do some wonky and unpredictable things. For example, a person with diabetes might experience dropping blood sugar levels, so she keeps eating, and then her blood sugar suddenly spikes.
With diabetes, your body doesn’t produce insulin (or at least enough insulin), so you have to manually regulate your insulin levels. This is harder than it sounds. Imagine, for example, if you stopped blinking involuntarily, and you had to regulate blinking. It would be incredibly difficult to get blinking down to an exact science. Calculating the right amount of insulin works the same way. As a result, blood sugar levels can sometimes get too low or too high.
Neither scenario is good on your eyes.
Blurring the Lines: Low Blood Sugar and the Eyes
Every cell in your body needs sugar to function properly. If blood sugar gets too low, your central nervous system begins to malfunction. This is called hypoglycemia.
A lot of symptoms come with hypoglycemia, but as it pertains to the eyes, your vision becomes blurred.
High blood sugar, however, can cause more damage and thus be more dangerous.
High Blood Sugar: How Failing Kidneys Swell the Eyes
Constant high blood sugar can actually damage parts of the eyes. That’s because when blood sugar is high, the eye swells and can change shape. To understand why, we first must look to the kidneys.
The kidneys play a big role in digestion. A simplified explanation of the digestion process is this: Food enters the kidney and gets separated into either protein or waste products. Protein travels through tiny blood vessels called capillaries. But for the waste products — each of the capillaries have tiny holes in them, through which the waste products are filtered. The protein is too big to fit through the holes, so they travel through the kidneys and convert into useful energy.
High blood sugar can disrupt this process. It causes the kidneys to filter too much blood, which is hard on the tiny holes. The tiny holes widen, so protein seeps out as a waste product. If this goes on too long, the kidneys become worse at filtering until they fail altogether.
So what does this have to do with the eyes?
When the kidneys don’t filter waste products the way they’re supposed to, the body has excess fluid in it. This excess fluid can accumulate around the eyes, especially at night, when gravity pulls the fluid that direction.
One symptom is puffy eyes.
But diabetes doesn’t stop at puffy eyes. The excess fluid causes the eye to swell. This leads to a ton of problems.
A Ton of Problems
The most serious condition is called diabetic retinopathy, which accounts for twelve percent of all new cases of blindness and is the leading cause of blindness for 20- to 64-year-olds.
Diabetic retinopathy deals with the lens inside your eyes called the retina, which is a light sensitive lining at the back of the eye. Blood vessels supply the retina. When the eye swells, these blood vessels can leak blood or other fluids into the retina, causing it to swell. The result is blurred or cloudy vision.
Unfortunately, extensive damage can often happen to the eye before you even notice any changes in your vision. If you’ve been diagnosed with diabetes, let your optometrist know immediately.
Diabetic Macular Edema
If the seeping from diabetic retinopathy isn’t handled immediately, it can culminate into another problem. Over time, blood and fluid can seep into the macula, which is the part of the retina that focuses light. When this happens, the condition is called diabetic macular edema (DME). Not only does this blur vision, colors might appear washed out to you.
Cataracts and Glaucoma
Diabetes can also lead to cataracts and glaucoma.
A cataract is a clouding of the eye’s lens. The lens helps with focus. Adults with diabetes are two to five times more likely to develop cataracts than adults without, and they often develop cataracts at an earlier age, too.
Glaucoma damages a bundle of nerve fibers that connect the eye to the brain (aka the eye’s optic nerve). This could be due to the swelling, as increased swelling leads to elevated pressure in the eye. An adult with diabetes has two times the risk of glaucoma as an adult without.
Sharpening the Focus on Diabetic Eye Disease
Going state by state, the American Diabetes Association reveals diabetes is growing at an epidemic rate in the United States. Nearly 30 million Americans have been diagnosed. As it pertains to Florida, diabetes affects about 2.4 million people.
Luckily, diabetic eye disease is considered rare, with fewer than 200,000 cases in the U.S. per year. However, according to the National Eye Institute, it has no warning signs and no cure. And diabetes is the leading cause of blindness in adults.
To prevent diabetic eye disease, control your blood sugar and blood pressure. Visit your optometrist if you are experiencing any of the following:
- Blurred vision
- Double vision
- Pain in your eyes
- Black spots in your vision
- Flashes of light
Likewise, schedule a dilated eye exam at least once a year.
The disease may not have an end in sight, but the earlier you can catch it, the better your vision for the future.