How does diabetes affect your vision: Q&A with Dr. Meet Chande and Dr. Jestyn Liew

According to Diabetes Canada, 15% of Canadians are living with diabetes. Regular eye exams and optimal glycemic control help reduces the onset and progression of sight-threatening diabetic retinopathy.

To mark Diabetes Awareness Month and World Diabetes Day this November, we caught up with Dr. Meet Chande and Dr. Jestyn Liew, to answer some common questions about diabetes and eye health.

How does diabetes affect vision?

Dr. Chande: People who have diabetes can be at risk of developing an eye condition called diabetic retinopathy, which affects the blood vessels in the retina (the light-sensitive layer of tissue at the back of your eye).

If these blood vessels become blocked or damaged, then the retina doesn’t receive a healthy blood supply and begins to malfunction. If diabetic retinopathy is left undiagnosed or untreated, it can lead to vision loss. But the good news is that finding it early can help you take steps to protect your vision.

What are the signs of diabetic retinopathy?

Dr. Liew: The signs tend to vary from person to person. The early stages of diabetic retinopathy usually don’t have any symptoms. Some people notice changes in their vision, like trouble reading, seeing faraway objects or in low light, but these may come and go.

In its later stages, the retinal vascular starts to change, we get blood vessels that start to leak fluid and blood. This can occur in the retina but can also occur with abnormal vessels growing and leaking blood into the vitreous (the gel-like fluid that fills your eye). If this happens, people may see dark, floating spots or streaks that look like cobwebs.

Sometimes, the spots clear up on their own — but it’s important to get treatment right away to avoid scarring that could affect your vision.

Can diabetes cause other eye conditions, like cataracts or glaucoma?

Dr. Liew: Yes, diabetes can put you at a higher risk of developing other conditions or worsen pre-existing conditions. The main ones are cataracts and glaucoma, but others can include retinal detachments and corneal disease (due to nerve damage that is common in diabetes).

How often should I have eye exams if I have diabetes?

Dr. Chande: Optometrists check for diabetic retinopathy as part of a dilated eye exam. They will give you some eye drops to dilate (widen) your pupil and then check your eyes for signs of diabetic retinopathy amongst many other eye conditions.

This should be done at least once per year, or more if your optometrist sees any further risks. Getting an OCT eye health scan can also help your optometrist to find the disease in its early stages, up to five years before you have any symptoms. The OCT has been a real game changer in retina care.

What can I do to protect my vision?

Dr. Chande: Managing your diabetes — by staying physically active, eating healthy, and taking your medicine — can help you prevent or delay vision loss.  Regular eye exams with OCT scans will also help your optometrist to catch any changes early and make sure you have a better prognosis.

Are there lifestyle changes that can help minimize the risk of eye complications?

Dr. Liew: Diabetes is a condition that affects the whole body, so a holistic approach is needed. Working with your team to address the disease is key, they can include: your family doctor, endocrinologist, dietician, eye doctor and personal support (friends and family) to keep you accountable.

Make sure to exercise regularly and follow a plan that you can stick to – little gains slowly lead to great changes. In addition, it’s important to monitor your blood sugar regularly, see your physician as recommended, and know your norms for A1C testing and fasting levels.

And, of course, making sure you see your optometrist (or ophthalmologist) regularly for eye exams.

If you or someone you know lives with diabetes, don’t forget to get an eye exam every year to help protect your vision.