retinopathy

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

Over time, high blood glucose may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetic eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (the part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which is the leading cause of blindness worldwide. It happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you have diabetes and:

• Have had diabetes for a long time
• Don't have good control over your high blood glucose or high blood pressure
• Are pregnant
• Have high blood cholesterol
• Smoke tobacco

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could be signs of an emergency. Call your eye care professional right away if you notice any of these symptoms:

• Many new spots or dark wavy strings floating in your vision (floaters)
• Flashes of light
• A dark shadow over part of your vision, like a curtain
• Vision loss
• Eye pain or redness

Talk with your eye care professional if you have these symptoms, even if they come and go:

• Spots or dark wavy strings floating in your vision
• Blurry or wavy vision
• Vision that changes a lot
• Trouble seeing colors

Eye care professionals do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your eye care professional can look for signs of eye problems and treat them before they harm your vision. They will also test your vision and measure the pressure in your eyes.

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

• Lasers to stop blood vessels from leaking
• Injections (shots) in the eye to stop new, leaky blood vessels from growing
• Surgery to remove blood and scar tissue or replace a cloudy lens
• Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Retinal disorders are conditions that affect the retina, the thin light-sensitive tissue at the back of your eye. The retina senses light and sends signals to your brain so you can see.

Retinal disorders can cause blurred or distorted vision. Some can lead to vision loss or blindness.

The causes of retinal disorders vary. Aging is a common factor, but other things can raise your risk, such as if you:

• Smoke
• Have obesity
• Have health conditions like diabetes or high blood pressure
• Have had an eye injury or trauma
• Have a family history of retinal disorders

Some common retinal disorders include:

• Macular degeneration. Occurs when the macula (the center of the retina that helps you see fine details) breaks down. There are two types: wet and dry macular degeneration.
• Diabetic retinopathy. Occurs when diabetes damages small blood vessels in the retina, causing them to swell or leak.
• Retinal detachment. Occurs when the retina pulls away from the back of the eye. This is a medical emergency.
• Retinal tears. A hole or break in the retina caused when the gel-like substance inside your eye (the vitreous) pulls away.
• Retinoblastoma. A rare cancer of the retina that most often affects young children.
• Macular pucker. Scar tissue that forms on the macula and distorts vision.
• Macular hole. A small opening in the macula, often related to aging or injury. It can blur or distort central vision.
• Eye floaters. Small specks, cobwebs, or threads that drift across your vision. These are more common with aging.
• Retina pigmentosa. A group of inherited disorders (passed down through families) that slowly damage the retina and cause loss of night and side (peripheral) vision.

Symptoms can vary, but most retinal disorders affect your vision. Common symptoms include:

• Blurred or distorted vision
• Loss of central or side (peripheral) vision
• Flashes of light
• Seeing floating specks or cobwebs
• Trouble seeing at night
• Sudden vision loss (in severe cases)

Seek medical care right away if you notice flashes of light, sudden vision changes, or a sudden increase in eye floaters. These can be signs of a serious retinal problem.

Eye care providers check for retinal disorders with a dilated eye exam. Eye drops are used to widen your pupils so your provider can look at the retina for signs of damage.

They may also do other tests, such as:

• Optical coherence tomography (OCT) to take detailed pictures of the inside of your eye.
• Fluorescein angiography to check the blood vessels in your retina.
• Visual field tests to measure your side (peripheral) vision.

Some retinal disorders can be treated to slow or stop vision loss, and sometimes to restore vision. Treatment depends on the cause and severity. It may include:

• Laser therapy
• Medicine or eye injections
• Surgery
• Lifestyle management to control health conditions such as diabetes or high blood pressure

Not all retinal disorders can be prevented. Some are related to aging or genetics. But you can protect your eyes by:

• Wearing safety goggles or sunglasses
• Getting regular eye exams
• Making healthy lifestyle changes, such as:
  • Quitting smoking (or not starting)
  • Managing diabetes and blood pressure

NIH: National Eye Institute

Almost 1 of every 10 infants born in the United States are premature, or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks.

Important growth and development happen throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Problems that a baby born too early may have include:

• Breathing problems
• Feeding difficulties
• Cerebral palsy
• Developmental delay
• Vision problems
• Hearing problems

Preemies need special medical care in a neonatal intensive care unit, or NICU. They stay there until their organ systems can work on their own.

Centers for Disease Control and Prevention

Eye care is about keeping your eyes healthy through good daily habits, regular checkups, and treatment when needed. Your eyes are an important part of your health. You rely on them every day to see and understand the world around you. Some eye diseases can lead to vision loss without early warning signs, so it's important to catch them as soon as possible. Get your eyes checked as often as your health care provider recommends, or if you notice new vision problems. Just like caring for the rest of your body, it's important to keep your eyes healthy.

There are many things you can do to protect your eyes and see your best:

• Give your eyes a rest. Spending long hours on a computer or other digital screens can make you blink less, causing dryness and tired eyes. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.
• Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
• Wear protective eyewear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
• Avoid rubbing your eyes. Rubbing your eyes can transfer dirt and bacteria that may cause irritation or lead to an infection.
• Use good lighting. Brighten your space to reduce strain and help you see comfortably.
• If you wear contacts, take steps to prevent eye infections. Wash your hands before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them and replace them when needed.

What you eat and how you take care of your body can have a big impact on your eyes and vision:

• Eat a healthy, balanced diet. Your diet should include plenty of fruits and vegetables, especially dark leafy green vegetables like spinach, kale, or collard greens. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
• Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
• Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. Regular exercise helps lower your risk.
• Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
• Know your family medical history. Some eye diseases are inherited (passed down through families), so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
• Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know your risk factors because you may be able to lower your risk by changing some behaviors.

Everyone needs their eyesight tested to check for vision and eye problems. Children usually have vision screening, also called an eye test, in school or at their provider's office during a checkup. This is a brief test that mainly checks how well you can see things up close and far away. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The eye exam includes several tests:

• Test your side (peripheral) vision with a visual field test. Losing peripheral vision may be a sign of glaucoma.
• Check how well you see at various distances with a visual acuity test, where you read an eye chart about 20 feet away.
• Follow an object with your eyes during an eye muscle function test to check for problems with the muscles that control your eyes.
• Shine a light into your eyes with a pupil response test to see how your pupils react to light.
• Measure the pressure inside your eyes with tonometry. This test helps to detect glaucoma.
• Dilate (widen) your pupils with special eye drops allows more light to enter the eye. Your eye care provider then uses a special magnifying lens to clearly see important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

How often you need eye exams depends on your age, race, risk factors, and overall health. For example, Black/African American adults are at higher risk for glaucoma and may need to start exams earlier. If you have diabetes, you should have an exam every year. Check with your provider about when you need these exams.

See an eye care specialist right away if you have symptoms like sudden loss of vision, double vision, blurred vision with eye pain, flashes of light, black spots or halos around lights. These symptoms may represent a serious medical or eye condition.