Diabetic retinopathy - care

Diabetes can harm your eyes. It can damage the small blood vessels in your retina, the back part of your eye. This is called diabetic retinopathy. Diabetes also increases your risk of having glaucoma, cataracts, and other eye problems.

You may not know there is any damage to your eyes until the problem is very bad. Your doctor can catch problems early if you get regular eye exams.

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

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

The eye exam may include:

• Dilating your eyes to allow a good view of the entire retina. Only an eye doctor can do this exam.
• At times, special photographs of the back of your eye

Your eye doctor may ask you to come more or less often than every year.

Control your blood sugar levels. High blood sugars increase your risk of having eye problems.

Control your blood pressure. Blood pressure less than 130/80 is a good goal for people with diabetes.

• Have your blood pressure checked often and at least twice per year.
• If you take drugs to control your blood pressure, take them as your doctor told you to.

Do not smoke. If you need help quitting, ask your doctor or nurse.

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

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

Make sure your home is safe from falls.

If you cannot read the labels on your medicines easily, these tips might help you make sure you are taking the correct medicine and the correct dose:

• Use felt tip pens to label medicine bottles so you can read them easily.
• Use rubber bands or clips to tell them apart.
• Ask someone else to give you your medicines.
• Always read labels with a magnifying lens.
• Use a pill box with compartments for days of the week and times of the day, if you need to take medicines more than once a day.

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

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

Use large-print cookbooks to make foods that are on your diabetes meal plan. Ask your doctor or nurse where you can get these books.

Call your doctor if:

• You cannot see well in dim light.
• You have blind spots.
• You have double vision (you see 2 things when there is only 1).
• Your vision is hazy or blurry and you cannot focus.
• You have pain in your eyes.
• You are having headaches.
• You see spots floating in your eyes.
• You cannot see things on the side of your field of vision.
• You see shadows.

American Diabetes Association. Standards of medical care in diabetes -- 2012. Diabetes Care. 2012 Jan;35 Suppl 1:S11-63.

In the clinic. Type 2 diabetes. Ann Intern Med. 2010 Mar 2;152(1):ITC1-16.

Inzucchi SE, Sherwin RS. Type 1 diabetes mellitus. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 236.

Inzucchi SE, Sherwin RS. Type 2 diabetes mellitus. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 237.