Diabetes eye care

If you have diabetes, you may not know there is any damage to your eyes until the problem is very bad. Your provider can catch problems early if you get regular eye exams.

If your provider finds eye problems early, medicines and other treatments may help prevent them from getting worse.

Watch this video about:Diabetes - retinal conditions

Every year, you should have an eye exam by an eye doctor (ophthalmologist or optometrist). Choose an eye doctor who takes care of people with diabetes.

Your eye exam may include:

• Dilating your eyes and using specialized equipment to allow a good view of the entire retina. Only an eye doctor can do this exam.
• At times, special photographs of your retina may replace the dilated eye exam. This is called digital retinal photography.

Your eye doctor may ask you to come more or less often than once a year depending on the eye exam results and how well your blood sugar is controlled.

Control your blood sugar levels. High blood sugar increases your chance of having eye problems.

High blood sugar can also cause blurred vision that is not related to diabetic retinopathy. This kind of blurred vision is caused by having too much sugar and water in the lens of the eye, which is in front of the retina.

Control your blood pressure:

• Blood pressure less than 130/80 is a goal for people with diabetes.
• Have your blood pressure checked often and at least twice each year.
• If you take medicines to control your blood pressure, take them as your provider instructs.

Control your cholesterol levels:

• Abnormal cholesterol levels can also lead to diabetic retinopathy.
• Your provider may prescribe medicines to help lower your LDL (bad cholesterol) and triglycerides. Take the medicines as directed.

Do not smoke. If you need help quitting, ask your provider.

If you already have eye problems, ask your provider if you should avoid exercises that can strain the blood vessels in your eyes. Exercises that may make eye problems worse include:

• Weight lifting and other exercises that make you strain
• High-impact exercise, such as football or hockey

If your vision is affected by diabetes, make sure your home is safe enough that your chance of falling is low. Ask your provider about having a home assessment done. For people with diabetes, the combination of poor vision and nerve problems in the legs and feet can affect balance. This increases the chance of falling.

If you cannot read the labels on your medicines easily:

• Use felt tip pens to label medicine bottles, so you can read them easily.
• Use rubber bands or clips to tell medicine bottles apart.
• Ask someone else to give you your medicines.
• Always read labels with a magnifying lens.
• Use a pillbox with compartments for days of the week and times of the day, if you need to take medicines more than once a day.
• Ask for a special glucose meter with a larger display or one that reads out your blood glucose value.

Never guess when taking your medicines. If you are unsure of your doses, talk with your provider, nurse, or pharmacist.

Keep medicines and other household items organized in a cabinet so you know where they are.

To make foods that are on your diabetes meal plan:

• Use large-print cookbooks
• Use a full-page magnifier
• Use a high-definition (HD) magnifier
• For online recipes, use the zoom function on your keyboard to make the font bigger on your monitor
• Ask your eye doctor about other low vision aids

Contact your provider if you have any of the following:

• Cannot see well in dim light
• Have blind spots
• Have double vision (you see two things when there is only one)
• Vision is hazy or blurry and you cannot focus
• Eye pain
• Headaches
• Spots floating in your eyes
• Cannot see things on the side of your field of vision
• See shadows

Diabetic retinopathy - care

American Academy of Ophthalmology website. Preferred practice pattern guidelines. Diabetic retinopathy PPP 2019. www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp. Updated October 2019. Accessed May 28, 2024.

American Diabetes Association Professional Practice Committee. 12. Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S231-S243. PMID: 38078577 pubmed.ncbi.nlm.nih.gov/38078577/.

Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.

Dhatariya KK, Umpierrez GE, Crandall JP. Diabetes. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 210.

Salmon JF. Retinal vascular disease. In: Salmon JF, ed. Kanski's Clinical Ophthalmology. 9th ed. Philadelphia, PA: Elsevier; 2020:chap13.

Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.