How to keep your eyes healthy when you have diabetes

Diabetes can damage eyesight. But the steps you take now can help you see clearly for years.
Diabetic man having eye exam

When you think about diabetes, you may think of it as just a blood sugar problem. But really, diabetes is a whole-body condition. High levels of blood sugar can, over time, damage blood vessels, including the tiny ones in the eyes.

One of the parts of the eye that’s most vulnerable? The retina at the back of the eye, says Mrinali Gupta, MD, an eye doctor and surgeon in Orange County, California. “If you think of the eye as a camera, the retina is like the film,” she explains.

The good news: With regular eye exams and early treatment, diabetic eye disease can be managed and treated. Here’s what you need to know.

4 facts about diabetic eye disease

There’s more than one type of diabetic eye disease. When you see an eye doctor for an exam, they will usually check for signs of these diabetes-related conditions: 

  • Diabetic retinopathy, which affects the blood vessels in the retina and, without treatment, can lead to vision loss or blindness. It can also lead to other serious eye conditions.
  • Cataracts, which cause the lens of the eye to become cloudy. Most people get cataracts as they age, but people with diabetes tend to get them younger.
  • Glaucoma, which harms the optic nerve – the part of the eye that connects to the brain.

Diabetic retinopathy is the most common eye disease. By age 40, 1 in 3 people with diabetes have developed some form of this eye disease, according to the National Institutes of Health. People who have had diabetes for a long time – around 20 or 30 years – are at the highest risk, says Dr. Gupta.

But other risk factors may include:

  • High blood pressure
  • High cholesterol
  • Smoking

Diabetic retinopathy often has no symptoms. In fact, in the early stages of diabetic retinopathy, people still see well and are unaware they have it. That’s why retinal eye exams are important for people with diabetes. 

Early diagnosis and treatment make a difference for diabetic eye disease. An eye doctor can spot problems early by dilating the pupils and examining the backs of the eyes. You can see either an optometrist or an ophthalmologist for an exam. An optometrist examines, diagnoses, and treats eye conditions. An ophthalmologist is a medical doctor who can perform more complex treatments, including surgery.

Think of your optometrist as your go-to for primary eye care. If you need treatment, you’ll likely also have an ophthalmologist on your team.

Have a Blue Shield vision* plan?
 
Then you have access to one of the largest networks of vision providers in California and the U.S. Some of these providers are located in convenient places like Costco, Walmart, and Lens Crafters. What’s more, a retinal eye exam is a covered benefit on most plans (copay or coinsurance may still apply). Need to find an optometrist or ophthalmologist near you? Use the Find a doctor tool.
 
Not sure if you have vision coverage? Log into your account or call the customer service line on the back of your Blue Shield member ID card. You may have vision coverage through another insurance carrier. If you do not have vision coverage, ask about enrollment options.**

How to protect your eye health

Go to the eye doctor as soon as you get diagnosed with type 2 diabetes. You may need to have your eyes dilated. This means the eye doctor will use special drops to widen the pupils so they can check the retina.

Get your eyes checked once a year (or more if needed). “In general, patients with diabetes need at least one dilated retinal exam per year. Those with retinopathy require more frequent monitoring and, potentially, treatment,” says Dr. Gupta. The deciding factor is the extent of the injury to the retina.

Regular appointments are not only an important way to monitor your vision. They also help you take care of your overall diabetes health.

Stay on top of your ABCs – A1C, blood pressure, and cholesterol. Keeping these numbers in check can help lower risk for diabetes complications, including eye problems, according to the Centers for Disease Control and Prevention. (Learn more about the connection between diabetes and heart health here.) 

Exercise and eat a healthy diet. Good-for-you habits like these can help control blood sugar, blood pressure, and cholesterol. We know eating healthy can be complicated. That’s why we offer Virta®, a nutrition program designed to treat type 2 diabetes from your eyes to your toes. Get started with Virta

Quit smoking (if you haven’t already). You know all the reasons smoking harmful to your lungs. But because it also damages the tiny blood vessels in the eyes, it increases the risk of vision problems in people with diabetes. If you need help quitting cigarettes, Blue Shield has free support programs that can support you each step of the way.