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Diabetes and Your Eyes What is Diabetes? Diabetes is a chronic disease that has no cure. It is a leading cause of death in Canada. Approximately 6% of Canadians have diabetes. An optometrist knows your eyes inside and out. opto.ca The Three Types of Diabetes Type 1 diabetes occurs when the body (specifically, the pancreas) no longer produces insulin. We need insulin to use sugar for energy. Approximately 10 per cent of people with diabetes have type 1 diabetes. An optometrist knows your eyes inside and out. opto.ca The Three Types of Diabetes Type 2 diabetes occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin that is produced. 90% of people with diabetes have type 2 diabetes. An optometrist knows your eyes inside and out. opto.ca The Three Types of Diabetes Gestational diabetes is a temporary condition that occurs during pregnancy. It affects approximately 3.5% of all pregnancies and involves an increased risk of developing diabetes for both mother and child. An optometrist knows your eyes inside and out. opto.ca Is Diabetes Serious? If left untreated or improperly managed, diabetes can result in a variety of complications, including: • heart disease; • kidney disease; • impotence; • nerve damage; • and eye disease! An optometrist knows your eyes inside and out. opto.ca Diabetes and the Eyes Diabetic eye problems include: • fluctuating vision; • cataracts; • glaucoma; • diabetic retinopathy. An optometrist knows your eyes inside and out. opto.ca Fluctuating Vision Diabetes can cause large shifts in nearsightedness and farsightedness as blood sugar levels fluctuate. An optometrist knows your eyes inside and out. opto.ca Diabetes Increases Cataract Risk A cataract is a clouded lens within the eye. Treatment is surgical removal of the cataract and replacement with an artificial lens. Cataract surgery is very safe and has excellent outcomes. An optometrist knows your eyes inside and out. opto.ca Diabetes and Glaucoma Diabetes can lead to blood vessel development in the drainage angle of the eye. This can raise eye pressure and cause glaucoma. The optic nerve gets damaged and peripheral vision is lost. An optometrist knows your eyes inside and out. opto.ca Diabetic Retinopathy Diabetic retinopathy is the most serious ocular complication of diabetes. An optometrist knows your eyes inside and out. opto.ca Diabetic Retinopathy One-third of diabetics have diabetic retinopathy. It is now the most common cause of blindness under age 65, and the most common cause of new blindness in North America. An optometrist knows your eyes inside and out. opto.ca Diabetes and the Eyes Many patients with retinopathy don't have any warning symptoms in the early stages of the disease. Routine eye examinations are the best method of detecting and preventing the development of severe blood vessel damage in the eyes. An optometrist knows your eyes inside and out. opto.ca Will I Get Retinopathy? The single most important risk factor is the length of time you've had diabetes. An optometrist knows your eyes inside and out. opto.ca Will I Get Retinopathy? Type 1 patients usually don't develop retinopathy until at least five years after the onset of the disease. After 15 years with diabetes, however, 98% of patients demonstrate some retinopathy. An optometrist knows your eyes inside and out. opto.ca Will I Get Retinopathy? In type 2 diabetes, the development of retinopathy happens much more quickly. One-fifth of type 2 patients show signs of retinopathy when their diabetes is first diagnosed. Ultimately, diabetes will cause changes in the eyes for 78% of type 2 patients. An optometrist knows your eyes inside and out. opto.ca What Happens With Diabetic Retinopathy? Diabetes damages the tiny blood vessels in the part of the eye called the retina. An optometrist knows your eyes inside and out. opto.ca What Happens With Diabetic Retinopathy? Over time, the ability to deliver blood (and oxygen) to the retinal tissues of the eye is lost. New, abnormal, weak blood vessels may start to grow. The new or existing blood vessels become "leaky." Blood and fat (blood lipid) can seep out of these damaged capillaries. This makes the retina bleed and swell. An optometrist knows your eyes inside and out. opto.ca Diabetic Retinopathy Hemorrhages & Soft Exudates An optometrist knows your eyes inside and out. Proliferative Retinopathy opto.ca Treatment: Laser Photocoagulation for Mild or Non-Proliferative Retinopathy The bright light of the laser is used to burn and seal off the damaged blood vessels so the leakage stops. The treatment is painless, using only eye drops to freeze the eye. The goal is to slow down the rate of visual loss. An optometrist knows your eyes inside and out. opto.ca Treatment: Laser Photocoagulation for Mild or Non-Proliferative Retinopathy The laser is used to create scars throughout the peripheral retina. A scarred retina needs less oxygen than an untreated retina — therefore the new abnormal blood vessels are no longer needed. This is a much more extensive technique, performed during three to four sessions over several weeks. The periphery of the retina has many nerves, and some patients find these treatments more uncomfortable. An optometrist knows your eyes inside and out. opto.ca Vitrectomy If bleeding in the eye is extensive, or associated with the formation of scar tissue and detached retinas, vitrectomy surgery may be necessary to remove scar tissue and the inner “jelly” of the eye. An optometrist knows your eyes inside and out. opto.ca Reducing the Risk of Diabetic Complications Early diagnosis and treatment – see your family physician for routine physicals. If you have diabetes – tight blood sugar control, control blood pressure and blood lipids, and… An optometrist knows your eyes inside and out. opto.ca Reducing the Risk of Diabetic Complications Routine eye examinations Diabetic retinopathy often presents with no visual warning signs! An optometrist knows your eyes inside and out. opto.ca Reducing the Risk of Diabetic Complications All patients diagnosed with type 1 or 2 should visit an optometrist or ophthalmologist for an eye exam. During the exam, eye drops will be used to dilate the pupils and a thorough retinal examination will be done. An optometrist knows your eyes inside and out. opto.ca Reducing the Risk of Diabetic Complications People with diabetes should have an eye examination at least once a year. Routine eye examinations are the best method of detecting and preventing the development of severe damage in the eyes. An optometrist knows your eyes inside and out. opto.ca your eyes deserve an optometrist