People with diabetes are at risk of a variety of eye diseases. The American Academy of Ophthalmology refers to diabetes-related eye problems under the umbrella term “diabetic eye disease.” Some of the conditions that are considered types of diabetic eye disease include:

• Glaucoma
• Diabetic retinopathy
• Diabetic macular edema
• Cataracts

If you’re living with diabetes, it’s important to tell your doctor about any new or worsening eye symptoms. Regular eye exams can help ensure that you get early treatment in case an eye condition develops. Here’s more information about diabetic eye diseases that you can discuss with your diabetes care team.

1. Glaucoma

Glaucoma is the second most common cause of blindness among adults in the United States, according to the American Optometric Association. This disease is the result of a process that involves:

• Fluid buildup in the eye
• High eye pressure
• Optic nerve damage

Your eye is always making a fluid called aqueous humor, which provides nutrients to the eye and maintains the eye’s shape. Aqueous humor needs to drain out to make room for newly produced aqueous humor. Otherwise, this fluid builds up and causes greater pressure in your eye.

High eye pressure can damage the optic nerve. This nerve in the back of the eye is directly connected to the brain. When light reaches the retina (the lining on the inside of the back of your eye), it sends signals via the optic nerve to the part of the brain that’s responsible for eyesight.

Damaged optic nerve fibers can’t communicate with the brain very well. This results in blind spots that you don’t notice at first. Vision loss increases as more optic nerve fibers are damaged and can lead to complete blindness.

Vision problems from glaucoma are permanent. However, with early detection, prompt treatments can prevent the condition from getting worse and preserve the vision you have. If you have diabetes, frequent and thorough eye exams are essential for detecting glaucoma in its early stages.

Types of Glaucoma Most Commonly Linked to Diabetes

There are many types of glaucoma. Diabetes increases the risk of these three types:

• Primary open-angle glaucoma — Occurs more commonly than other types among people with diabetes, particularly type 2 diabetes
• Steroid-induced glaucoma — Can occur in people who take steroid eye drops or injections for other eye problems
• Neovascular glaucoma — Develops in people with diabetic retinopathy and causes blood vessels to grow abnormally, blocking the drainage of the aqueous humor

Glaucoma Diagnosis

Glaucoma doesn’t cause symptoms in the early stages. An ophthalmologist (eye doctor) can detect the condition in a complete eye exam. A more limited eye exam that tests only eye pressure won’t reveal glaucoma. During a complete glaucoma exam, your eye doctor will:

• Check your eye drainage
• Test your peripheral (side) vision
• Take pictures of your optic nerve

2. Diabetic Retinopathy

The retina contains specialized cells that capture light and allow us to see. “Retinopathy” means “disease of the retina.” In people with diabetic retinopathy, high blood sugar (glucose) levels can damage the retina’s tiny blood vessels. High blood glucose can cause blood vessels to leak, swell, or close off, preventing oxygen and nutrients from reaching the retina.

Types of Diabetic Retinopathy

There are two types of diabetic retinopathy — nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

NPDR is early-stage retinopathy and is common in people with diabetes. In NPDR, retinal blood vessels damaged by high blood sugar may eventually close off. People with NPDR may notice blurred vision, but mild symptoms don’t always require treatment.

PDR is late-stage diabetic retinopathy and is a serious condition. In this type, the retina forms new, abnormal blood vessels. These new blood vessels can bleed into an area in the middle of the eye called the vitreous humor. People with PDR may notice floaters (shadowy specks moving in the eye) or loss of vision due to this bleeding. The abnormal blood vessels can also form scar tissue that may pull on the retina, causing it to detach. If not treated, this condition can cause permanent, severe vision loss.

Treatment for Diabetic Retinopathy

There are several treatments for NPDR and PDR, including:

• Steroid injections (shots or implants) to reduce swelling
• Anti-vascular endothelial growth factor (anti-VEGF) injections to stop the growth of abnormal blood vessels and reduce swelling
• Laser treatments to close leaky blood vessels, as well as shrink abnormal new blood vessels and prevent them from growing
• Vitrectomy, an eye surgery that removes scar tissue and blood in the eye

3. Diabetic Macular Edema

Some people with diabetic retinopathy develop diabetic macular edema (DME), which affects a part of the retina called the macula. The macula is in the center of the retina and is responsible for your central vision. Damage to the macula makes recognizing faces and reading difficult.

People with diabetes need regular eye exams to check for macular edema, which is the leading cause of blindness among people with diabetic retinopathy.

Fluid from leaky blood vessels caused by diabetic retinopathy can build up in the macula and cause it to swell. “Edema” is the medical term for “swelling due to fluid buildup.”

People with diabetes need regular eye exams to check for macular edema. Diabetic macular edema is the leading cause of blindness among people with diabetic retinopathy. It’s important to work with your doctor and stick to a treatment plan to prevent vision loss.

4. Cataracts

A cataract is a clouded area in the lens, a normally transparent part of the eye behind the iris (colored part of your eye). It’s responsible for helping the eye focus and see things sharply. Cataracts usually develop slowly as people age. However, people with diabetes can develop cataracts rapidly and at younger ages.

High blood sugar levels can cause changes in the lens and lead to clouding. People with cataracts may first notice blurred vision. Cataracts may also give bright colors a dull or yellow hue. When cataracts affect the whole lens, they can lead to blindness.

Eyeglasses can treat some vision problems caused by cataracts. However, if vision problems from cataracts affect your quality of life, you can ask your eye doctor about cataract surgery. During this procedure, the cloudy lens is removed and replaced with an artificial lens.

5. Retinal Vein Occlusion

Diabetes increases the risk of retinal vein occlusion, which occurs when the veins that carry blood away from the retina become blocked. Symptoms include blurry vision and the inability to see out of one eye, either suddenly or over the course of a few days.

It’s important to contact your eye doctor immediately if you develop these symptoms — untreated retinal vein occlusion can lead to vision loss.

6. Dry Eye Syndrome

About 54 percent of people with diabetes develop dry eye syndrome, also known as dry eye disease and keratoconjunctivitis sicca. Dry eye syndrome can be a serious complication because the eyes require constant tear production to stay moist and function properly. Dry eye syndrome is often linked to other conditions that affect the eyes.

Dry eye syndrome can occur with diabetes because low insulin levels can lead to decreased tear production. High blood glucose levels can also damage nerves that regulate tear production and blood flow to the eyes, which helps tears stay on the eye. In addition, inflammation from diabetes is believed to impair the lacrimal gland, reducing its ability to produce oils that keep tears from evaporating too quickly.

Symptoms of dry eye syndrome include:

• Persistent burning, stinging, or discomfort, especially when wearing contact lenses
• Eye redness
• Mucus buildup in the eyes
• Blurry vision
• Heightened sensitivity to environmental factors such as wind and smoke
• Excessive tearing (a reaction to dryness)

Treatment options include different types of eye drops and managing the underlying causes of dry eye syndrome, such as high blood pressure and high blood sugar.

7. Double Vision

Diabetes can cause damage to cranial nerves, which control the muscles responsible for eye movement, potentially leading to double vision. Cranial nerves originate in the brain and manage various functions in the head and face, including those related to sight.

This kind of double vision often improves on its own within a few months. However, prism lenses, which are added to eyeglasses, can be used to help manage the symptoms. In some cases, surgery may be recommended if the condition doesn’t resolve naturally.

Follow Up With Your Eye Doctor

Medical experts recommend that people with type 1 diabetes have eye exams within five years of their diabetes symptoms first appearing. People diagnosed with type 2 diabetes should schedule an eye care appointment right away to look for early signs of diabetic eye disease.

Your eye doctor can help you set up follow-up exams depending on your eye health. Always report any vision changes, and make sure to go to an eye specialist if you’re referred to one. Most eye problems due to diabetes can be treated if found early, and prompt treatment can prevent you from losing your vision.

Talk With Others Who Understand

On DiabetesTeam, the online social network for people with diabetes and their loved ones, more than 158,000 members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Have you had diabetes-related eye problems? Have you been treated for a particular condition? Share your experience in the comments below, or start a conversation by posting on your Activities page.