8 Strategies To Prevent Eye Disease
Blood sugar management, exercise, and annual screenings all help reduce the risk of diabetes-related eye disease. Here are more top tips for keeping your eyes as healthy as possible.
Sight is undoubtedly one of our most valuable senses, yet diabetes can threaten vision in a variety of ways. High blood sugar can damage blood vessels all over the body, including in the eyes.
As a result, people with diabetes are especially at risk for four types of eye disease: diabetes-related retinopathy, diabetes-related macular edema, cataracts, and glaucoma. Here’s more on each condition – plus simple strategies to keep your eyes healthy in the long run.
Diabetic retinopathy
The retina is a part of the eye that enables us to see. Like film in a camera, the retina is a layer of light-sensitive cells in the back of your eye where images are imprinted. Blood vessels in the retina provide nourishment to these cells so that you can see clearly. Over time, diabetes can cause these blood vessels to weaken and leak, resulting in diabetic retinopathy.
More than one-quarter of people are estimated to have diabetes-related retinopathy in the U.S., making this the most common eye disease among those with diabetes. In the early stages, there are often no symptoms. The best way to prevent or care for your eyes during these early stages is to get annual eye exams and manage your blood sugar through lifestyle changes and drug therapies.
As the disease progresses to the more advanced stage, abnormal blood vessels grow, which can cause blurred vision, floaters (floating shapes in your vision), and ultimately vision loss.
There are treatments available for advanced diabetic retinopathy, but some are quite invasive and require multiple visits with your eye doctor. These include eye injections to slow the growth of new and unusual blood vessels or laser therapy to stop the bleeding of vessels. Researchers have developed newer injection treatments that reduce the frequency of required eye injections.
Diabetic macular edema
The macula is an oval-shaped part of the retina that provides central vision – your clearest, most detailed vision that allows you to see directly in front of you.
Blood vessels in the retina typically supply nutrients to the macula, but diabetes-related retinopathy can cause these vessels to leak blood into the macula. This creates swelling known as macular edema. Like retinopathy, diabetes-related macular edema is treated with eye injections and laser treatments.
Cataracts
For most young people, the lens in our eye is clear and focuses light on the retina. The lens of the eye may become cloudy with age or due to diabetes. Cataracts may cause blurred vision, light sensitivity, poor night vision, or yellowish and brown tints to certain colors.
Cataracts are quite common in many people as they grow older, but according to scientific research, people with diabetes are two times more likely to develop cataracts. Diabetes can also cause an earlier onset of cataracts.
Cataracts can be treated by an eye surgery that takes about 15 minutes. The procedure replaces your cloudy eye lens with an artificial lens that can restore vision.
Glaucoma
Like cataracts, glaucoma is an eye condition that affects people with and without diabetes. In healthy eyes, a drainage system allows fluid to leave the eye to maintain normal pressure. With glaucoma, an imbalance in this pressure can damage the optic nerve.
Diabetes also raises the risk of glaucoma. Over time, the condition may cause vision loss and blindness. As with diabetic retinopathy and macular edema, there’s no cure for glaucoma, however, prescription eye drops and laser treatments can slow its progression.
Tips to protect your eyes
Despite these forms of diabetes-related eye disease, the Centers for Disease Control and Prevention (CDC) estimates that 90% of vision loss from diabetes is preventable. Here are top strategies to protect your vision:
1. Set up annual appointments
When was your last eye exam? How about your next eye doctor appointment? The American Diabetes Association recommends every person with diabetes have at least one dilated eye exam each year with an ophthalmologist or optometrist.
However, data from the American Academy of Ophthalmology show that 60% of people with diabetes in the U.S. don’t get annual eye exams. These eye appointments are very important – serious eye diseases, like diabetic retinopathy, can develop over time without you even noticing. A comprehensive eye exam can catch a diagnosis early and help you get the necessary treatment to prevent disease progression.
In a dilated exam, your eye doctor will give you drops to enlarge your pupils so they can look at your retina. The process is pain-free but there are some very mild, temporary side effects (light sensitivity and blurry vision). If no retinopathy is found, you may be able to return in two years for your next visit.
During your appointment, tell your eye doctor about any changes in your vision and ask that the results of your visit be shared with your healthcare provider or endocrinologist. At your next appointment with your primary care physician, update them on how your eye exam went.
2. Manage blood glucose
To the best of your ability, try to keep blood glucose levels within a target range, usually 70-180 mg/dL. Maintaining stable blood glucose levels can help prevent eye disease, as well as slow the progression of existing eye conditions.
Healthy lifestyle habits, like eating a nutritious diet and getting regular physical activity, can help manage blood sugar levels. Beyond lifestyle changes, medications like GLP-1 receptor agonists and SGLT-2 inhibitors can also help people with type 2 diabetes improve their glycemic control.
Additionally, diabetes technology like continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems can provide detailed insights into trends in your glucose levels. Ask your healthcare provider about newer medications, technologies, and other strategies to manage blood sugar.
3. Manage blood pressure and cholesterol
High blood pressure and cholesterol levels can cause the blood vessels in your eyes to become blocked, making them leaky, which will hurt your vision.
Guidelines from the ADA target blood pressure under 130/80 mmHg and LDL cholesterol (“bad” cholesterol) under 70 mg/dL; however, these values may not work for everyone. Ask your healthcare provider what blood pressure and cholesterol goals make sense for you.
4. Pay attention to changes in vision
Are you noticing spots in your vision? Blind spots? Flashing lights? In the time between annual visits with your eye doctor, track any changes in your vision. One way is to give yourself an at-home eye test. If you notice symptoms but your annual visit is still months away, schedule an appointment sooner.
5. Don’t smoke
It’s known that smoking hurts your health in a variety of ways, but did you know it can damage your eyes, too? In general, smoking increases the risk of dry eyes, cataracts, and optic nerve problems. For people with diabetes, smoking increases the odds of developing diabetic retinopathy and can worsen existing eye disease.
In addition to helping your eye health, after quitting smoking your risk of heart disease, cancer, and other chronic conditions goes down as well.
6. Get exercise
Exercising can help you manage your diabetes, which in turn will have positive effects on your eyes. For example, if you already have diabetes but have not developed retinopathy, exercise can help you maintain healthy blood sugar levels to reduce your risk of future disease.
The ADA recommends at least 150 minutes per week of moderate to vigorous aerobic activity. This includes anything that gets your heart pumping, such as brisk walking, jogging, cycling, dancing, or swimming.
Strive to incorporate strength training into your weekly routine, as this form of physical activity can increase your insulin sensitivity. With improved insulin sensitivity comes better glycemic control and a reduced risk of developing diabetes-related eye disease.
7. Wear sunglasses
Eyes can be easily protected from the sun by wearing sunglasses and protective eyewear. Sunglasses shield your eyes from the sun’s harmful ultraviolet rays and should be worn year-round, even on cloudy days. When purchasing sunglasses, look for a pair that blocks 99-100% of UVA and UVB rays.
8. Rest your eyes using the 20-20-20 rule
Many of us spend hours each day looking at computers or phones, making our eyes feel tired and strained. Next time your eyes start to ache, consider using the 20-20-20 rule. After 20 minutes of screen time, look away from your screen and focus on a spot 20 feet away from you for 20 seconds. This will help prevent eye strain, making your long days in front of the computer more manageable.
The bottom line
What should you do next? If you don’t have one set up, make an appointment for a dilated eye exam and make sure to schedule them annually. Ask your eye doctor what other steps you can take to protect your eyes from the onset or progression of diabetes-related eye conditions.
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