Johns Hopkins Health Alerts | Vision | Are You at Risk for Diabetic Retinopathy

Diabetic retinopathy usually has no symptoms, so if you have diabetes it’s important to follow these five steps to reduce your risk of developing retinopathy.

Diabetic retinopathy, a potential long-term complication of diabetes, is an eye disorder caused by damage to blood vessels in the retina, the light-sensitive tissue at the back of the eye. Mild forms of the disorder are common: Almost all people with type 1 diabetes and more than 70% of people with type 2 diabetes will experience some degree of retinopathy. Without treatment, diabetic retinopathy can progress from mild, nonproliferative retinopathy to more serious proliferative retinopathy, which can lead to blindness.

What can you do? People with diabetes can take these steps to help reduce their risk of developing retinopathy or having their retinopathy progress.

• Retinopathy Tip 1: Have Regular Eye Exams. Regular visits to an ophthalmologist are essential to detect early retinal damage so it can be monitored and, if necessary, treated with laser therapy. An annual eye exam is recommended for people who have had type 1 diabetes for more than five years. Everyone with type 2 diabetes should have an eye exam as soon as diabetes is diagnosed, and annually thereafter.
• Retinopathy Tip 2: Control Blood Glucose. The most important way to prevent diabetic retinopathy is to keep blood glucose levels as close to normal as possible. This is because high blood glucose levels can damage blood vessels in the retina. The best way to achieve tight glucose control and reduce your risk of developing diabetic retinopathy is to measure your blood glucose levels frequently with a glucose monitor and to follow the advice of a doctor who manages diabetes aggressively. It is also important to have a hemoglobin A1c (HbA1c) test every three to six months to evaluate your blood glucose control. Experts recommend that people with diabetes maintain an HbA1c level below 7%. Studies have found that every 10% reduction in elevated HbA1c levels is associated with a 39% reduction in the risk of diabetic retinopathy.
• Retinopathy Tip 3: Control Blood Pressure. High blood pressure can also damage blood vessels in the retina and cause retinopathy. Research shows that keeping blood pressure as close to normal as possible can help prevent the onset and progression of retinal damage. Experts recommend that people with diabetes keep their blood pressure at or below 130/80 mm Hg to prevent long-term complications.
• Retinopathy Tip 4: Control Cholesterol Levels. Studies have reached conflicting conclusions as to whether high blood cholesterol is associated with the development or progression of diabetic retinopathy. However, lowering blood cholesterol levels is already a priority for people with diabetes because of their increased risk of heart attack and stroke, and preserving vision may be an added benefit of taking steps to lower cholesterol.
• Retinopathy Tip 5: Stop Smoking. Some -- but not all -- studies find that smoking cigarettes is a risk factor for diabetic retinopathy. Even if there is no direct link, the blood pressure-raising effect of smoking can increase the risk of retinopathy.

Recognize the Warning Signs of Retinopathy: Diabetic retinopathy usually has no symptoms. However, any of the following visual changes could indicate retinal damage, and you should contact your eye doctor immediately if you experience any of them:

• sudden loss of vision in one eye
• blurred vision
• problems reading
• double vision
• pain in one or both eyes
• pressure in your eyes
• the appearance of spots or floaters
• problems seeing things with your peripheral vision

Johns Hopkins Health Alerts | Vision | Are You at Risk for Diabetic Retinopathy