if you have ever been diagnosed with diabetes then your medical doctor is going to want you to have
an eye exam. but what is your eye doctor looking for and what does that mean when it comes to your
eye health your vision and your overall systemic health? To answer that, in this video we're going
to review the top five signs and symptoms of how diabetes affects the eyes let's take a look
hello and welcome this is Dr. Allen here from the doctor Eye health show helping you learn all about
the eyes, vision and finding the best vision products. now today we are talking about a very
important topic in eye care and overall all of healthcare because diabetes significantly affects
our eyes and our overall systemic health so if you were recently diagnosed with diabetes or maybe you
have a family member or friend who is diagnosed this is important to understand and the reason
that an eye exam is so important for anybody who is diabetic is because through the eye that
is the only way that your doctor can physically just stare at your blood vessels and see what is
going on because ultimately the way diabetes hurts your body is because it damages the blood vessels
so how does diabetes affect the eyes the first way that i want to mention is that of blurred
vision now not everybody will experience blurred vision when they are diabetic in fact i would say
most people probably won't and that's why having an eye exam is so important because you may not
feel like anything symptomatically is going wrong with the eye but that doesn't mean that
things aren't getting worse but diabetes can cause blurred vision and fluctuations in your eyesight
namely because elevated levels of sugar in your bloodstream can cause an accumulation of what is
called sorbitol uh basically a sugar alcohol to build up inside the lens inside of the eye you
see inside the eyeball we all have what is called a crystalline lens this lens helps focus the light
to the back of the eye to the retina so that you can see clearly the issue is that with elevated
blood sugars this lens can begin to almost swell in a little bit of a way but really the crystals
inside start to harden and change what's called the refractive index which basically increases
or decreases the power of this lens which can shift your refractive power or your focusing
either too strong or too weak and so then your glasses or your prescription for glasses can
become either highly more nearsighted or myopic or it can become hyperopic or farsighted now this
usually happens for people who are recently diagnosed with diabetes or blood sugars are
very much out of control thankfully with diet lifestyle modifications and medications
as your blood sugars get down more toward normal this lens change can go back to normal and so
if you have a sudden change in your glasses prescription then thankfully with normalized
blood sugars that may return to normal which just an fyi if you see an eye doctor and they're
concerned about that refractive change they may not prescribe you glasses because they know that
if you get glasses made with that prescription, in three four months later you're likely gonna
need a new prescription again i myself have written lab orders and referred to medical
doctors to get diabetes checked for patients because we've seen this big refractive change
but again thankfully if you can keep your blood sugars stable then hopefully you won't see this
type of shift now blurred vision and even loss of eyesight can come from diabetes and that's mainly
because of what's called macular edema that's where the retina in the back of the eye begins to
swell sort of like a blister you know how you can get a blister unlike your finger and it's
kind of filled with a clear fluid that's kind of like what's happening in the back of the eye
diabetes can cause weakened blood vessels within the whole body and when that's in the retina in
the back of the eye it can leak this clear fluid creating a blister-like effect within
the retina and this swelling of fluid within the retina basically causes damage or a change
in the architecture of the retina and then your vision just isn't clear things can seem
blurry and out of focus and what stinks is that with macular edema it can occur at any stage of
diabetes for people who are recently diagnosed or for people who have been diagnosed for 20 years
macular edema can come at any time and before any other retinal signs or changes so this is a big
thing eye doctors have to look for and sometimes this macular edema can even occur without vision
problems or vision loss so it's something that eye doctors like myself have to really be paying
attention to now while yes blurred vision and vision changes are our number one on this list
but keep in mind again that many people don't ever experience vision loss or vision changes with
diabetes so it's super important to still get your eyes checked now the second sign or symptom of how
diabetes affects the eyes is seeing spots in your vision now the spots that i'm referring
to are not the same thing as eye floaters which we've talked about in many other videos
and if you're seeing spots drifting around in your vision i do encourage you to check out those other
videos on Eye Floaters just to understand more what could be going on in short what i mean by
eye floaters are these little spots that kind of drift back and forth in your vision and for most
people are a normal occurrence of age and it's a buildup of proteins that are stuck inside the gel
inside the back of the eye called the vitreous humor but when it comes to somebody who is
diabetic if they suddenly experience these new spots in their vision or these kind of floating
like disturbances in their eyesight that may not just be an eye floater but it could in fact mean
one of the blood vessels inside the eye has burst open and is leaking blood into that gel inside
the eye and we call that a vitreous hemorrhage now even though what i'm talking about is blood stuck
inside the eye funny enough most people rarely experience or see these spots in their vision
as a red or a brown color most people do just see them as these black floating spots but i have had
at least a few patients tell me that they think they can see this brown thing floating around
the big concern for vitreous hemorrhage is that often means there is a growth of abnormal blood
vessels occurring inside the eye within the retina itself and that can be very serious with diabetes
and that brings us to number three on our list of how diabetes affects the eyes and that is through
retinal hemorrhaging or bleeding within the retina that's probably the number one thing that most eye
doctors are going to be observing or looking for during a diabetic eye exam they're going to look
behind a slit lamp or using different pictures to look in the back of the eye to look for subtle
small out pouching and bleeding spots within the retina tissue and when we see this bleeding
or damage in the retina we call that diabetic retinopathy and the reason that finding diabetic
retinopathy is so important is because if we're seeing damage to the blood vessels occurring
because of diabetes then we know that different levels of severity of diabetes are occurring not
just in the eyes but they're occurring in the rest of the body especially the kidneys and potentially
even the brain but again the scary thing is that for a lot of diabetics out there they
may not have any visual changes or notice anything going on yet they are bleeding within the retina
and the retina doesn't have any pain sensors so even again this is occurring and you don't
feel pain in the eye because of this so really a patient who is diabetic may not experience any
symptoms at all yet they are bleeding in their eyeball again just stressing why diabetic eye
exams are so important now moving on to the fourth way that diabetes can affect the eyes and that is
through new blood vessels that can grow inside the eye through a medical term that we call
neovascularization you see what there's bleeding inside the retina that means that blood is not
properly getting to the tissue that means no oxygen and other nutrients getting to the starved
tissue of the retina and when that happens your body wants to get that nutrients to that tissue
and so it grows new blood vessels the problem is that these new blood vessels are
fragile and they break very easily and this is one of the biggest concerns that eye doctors have
when we're looking for diabetes because if we see these irregular blood vessels growing you're
at an increased risk of really traumatic problems with the eyes if these abnormal blood vessels grow
and potentially break they not only leak blood and fluid into the eye but they also have a tendency
to cause fibrotic scars to form and when these fibrotic scars form inside the eye they can lead
to our fifth sign of how diabetes can affect the eye and that is what's called a retinal detachment
essentially these new blood vessels form inside the eye when they leak this fluid and this fibrous
scar forms the fiber scar basically bunches up really tight and pulls all of the tissue of the
retina off the back of the eye and unfortunately a retinal detachment is extremely serious and the
prognosis of recovery even with retinal surgery is very poor and for many of our patients who are
diabetic either with poorly controlled blood sugar levels or have just been diabetic for a long time
if they do have these irregular blood vessels growing or they're at risk of it your surgeon will
often use a laser or use a combination of lasers and injections of medications to help control
these new blood vessels from growing if lasers do need to be used for this case in terms of diabetes
then oftentimes they're using it to burn the blood vessels and that also burns the retina
so it can cause problems with vision loss but again they're doing that because they don't want
the blood vessels to grow irregular and lead to something catastrophic such as a retinal
detachment now the whole point of this video is not to just mention how terrible things can be
for the eyes with diabetes it is true diabetes can be very serious when it comes to the eye
and is a big part of my education a lot of a lot of my education as an eye doctor is about diabetes
i hope instead this video gives you a little bit more insight of ways that diabetes can affect
the eyes and how your eye doctor is going to be looking at your eye and the things that they're
going to be evaluating for and just so you have a frame of reference at the timing of this video
it is recommended that the standard of care if you're diabetic you are getting at least
one dilated eye exam a year if not more if you have more severe signs of progressive or worsening
diabetic retinopathy but probably the biggest message that i really would like people to hear
is that if you are pre-diabetic recently diagnosed as diabetic or maybe you've been diabetic for 20
years to know that changes in your diet your lifestyle as well as taking medications there
is possibility now there's evidence for it that we can put diabetes into remission for
a lot of people especially if it's just an earlier diagnosis and just to provide you with more useful
information i'll put links to other youtube videos with other healthcare professionals
who specialize in nutrition diabetes and to help you through that journey i'll put those links in
the description below that like button for you also if you're not subscribed to this channel
i do encourage you to do so because we will be having some future videos all about different
vitamins and nutrition about diabetes and diabetic retinopathy specifically there's in fact a lot
of good science on that topic that's just not shared across youtube or other resources very
well and so i plan to do a full breakdown of some of that research either way thank you so
much for watching again Dr. Allen here keep an eye on it and we'll see in the next one