By Walter Moscoso, MD

Diabetes is the leading cause of both kidney failure and blindness in American adults. Just as diabetes causes the kidneys to work much harder to process the increased blood sugar, patients with diabetes are more likely to develop eye problems. Diabetic eye diseases include cataracts and glaucoma, but diabetic retinopathy is the most common and most serious eye complication of diabetes.

Diabetic retinopathy is the medical term for damage to the tiny blood vessels (capillaries) that nourish the retina. These blood vessels are often affected by the high blood sugar levels associated with diabetes, resulting in fluid leakage in the retina, closure of blood vessels, or even the development of new blood vessels, which can reduce vision.

The threat of blindness is scary, but with early detection and treatment, the risk of severe vision loss from diabetic retinopathy is significantly reduced. Malnutrition, pregnancy, smoking and poorly controlled blood pressure can also cause retinopathy to worsen.

You can have diabetic retinopathy without knowing it. Usually, there is no pain and no outward sign. Over time, you may notice gradual blurring or some vision loss, but symptoms may come and go. Early treatment and reducing risk factors may help prevent vision loss or blindness. Since it often goes unnoticed by a patient, regular, dilated eye exams by an ophthalmologist are extremely important.

The three most common treatments for diabetic retinopathy include laser treatment, eye injections and surgery. The type of treatment your ophthalmologist selects for you depends on your condition. Laser treatment and eye injections sometimes help to stop leaks and limit new vessel growth. Surgery is performed when the retina detaches or the eye becomes filled with blood and obscures your vision.

Here are several steps that I advise my diabetic patients to take to reduce the risk of vision loss:

1) Keep an eye on vision changes. In addition to getting an annual eye exam, be alert to any sudden changes in your vision.

2) Work with your medical doctor to keep your blood sugar, blood pressure and fat levels as normal as possible.

3) Stop smoking. Smoking is especially bad for people with diabetes because it promotes the closure of blood vessels.

4) Control stress. Stress may affect your ability to control your blood sugar; for example, you may be too busy to exercise or eat a good meal. Stress hormones also can directly affect your blood sugar levels, causing them to rise or fall.

5) Keep all of your medical appointments for regular exams and treatments.

Walter Moscoso, MD, is a Board-Certified Ophthalmologist, Fellowship- Trained Retina Specialist. He’s a senior partner at Manatee Sarasota Eye Clinic and Laser Center in Sarasota, FL.