Can you lose your eyesight from diabetes?

Yes. Untreated diabetic eye disease can cause serious, sometimes permanent vision loss. Most of that risk can be lowered with good blood sugar and blood pressure control, a dilated eye exam at least once a year, and prompt treatment when changes are found.

How often should someone with diabetes have an eye exam?

Most people with diabetes should have a comprehensive dilated eye exam at least once a year, even with no vision symptoms, or more often if their eye doctor recommends it. Learn what that visit includes on our diabetic eye care page.

Can vision loss from diabetes be reversed?

Treatment can often stop diabetic eye disease from getting worse, and some people regain some vision when swelling in the retina improves. Damage that has gone untreated for a long time is more likely to be permanent, which is why early detection matters so much.

Who treats diabetic eye disease?

Optometrists and ophthalmologists both perform dilated diabetic eye exams and monitor the retina over time. When treatment such as injections, laser or surgery is needed, it is provided by ophthalmologists, including those who focus on retinal care.

Diabetes and Your Eyes: Eye Disease, Symptoms and Prevention

Q: Is blurry vision a sign of diabetes?

It can be. High blood sugar can make the lens inside your eye swell, causing blurry vision that comes and goes, and this is sometimes one of the first signs that leads people to discover they have diabetes. If you have unexplained blurry vision, see your primary care doctor and an eye doctor.

Diabetes affects nearly every part of the body, and your eyes are no exception. High blood sugar can quietly damage the tiny blood vessels in the back of the eye for years before you notice any change in your vision. Diabetic eye disease is one of the leading causes of vision loss in working-age adults, yet much of that vision loss can be prevented.

Whether you were just diagnosed or have managed diabetes for decades, here’s what you need to know about how diabetes affects your eyes, which symptoms need attention, and what you can do to protect your sight.

The Short Answer

Diabetes can damage the retina, the light-sensitive tissue at the back of the eye, and raises your risk of cataracts and glaucoma. Early diabetic eye disease usually has no symptoms, so a dilated eye exam at least once a year is the best way to catch it. Keeping your blood sugar, blood pressure and cholesterol in a healthy range lowers your risk, and when problems are found early, treatment can often prevent serious vision loss.

How Does Diabetes Affect Your Eyes?

Over time, high blood sugar weakens and damages small blood vessels throughout the body, including those that nourish the retina. Diabetes can affect your eyes in several ways.

Diabetic Retinopathy

Diabetic retinopathy is the most common diabetic eye disease. It develops in stages:

Nonproliferative diabetic retinopathy (earlier stages): Damaged blood vessels in the retina bulge, leak fluid or blood, or become blocked. Vision is often still normal at this point.
Proliferative diabetic retinopathy (advanced stage): As blood flow to the retina drops, the eye grows fragile new blood vessels. These can bleed into the gel that fills the eye (the vitreous), form scar tissue, and in some cases pull the retina away from the back of the eye (retinal detachment).

Retinopathy can develop with type 1 or type 2 diabetes. Generally, the longer someone has had diabetes, and the less stable their blood sugar has been, the higher the risk.

Diabetic Macular Edema

The macula is the small central part of the retina you use for reading, recognizing faces and driving. When leaking blood vessels cause fluid to build up there, it’s called diabetic macular edema. It can blur or distort your central vision and can occur at any stage of retinopathy.

Cataracts

A cataract is a clouding of the eye’s natural lens. People with diabetes tend to develop cataracts more often and at a younger age, which can cause blurry vision, glare and faded colors. Learn more about the symptoms of cataracts.

Glaucoma

Glaucoma damages the optic nerve, which carries signals from the eye to the brain, and often causes no symptoms until vision is lost. Diabetes raises the risk of glaucoma. In advanced diabetic retinopathy, abnormal blood vessels can also grow on the iris and block the eye’s drainage system, causing a serious form called neovascular glaucoma. Read more about the symptoms of glaucoma.

Temporary Blurry Vision From Blood Sugar Swings

Not every vision change from diabetes is permanent. When blood sugar is high, the lens inside the eye can swell and change shape, making vision blurry. Vision may also fluctuate for a while after starting or adjusting diabetes treatment as blood sugar levels come down. This kind of blurriness usually settles once blood sugar is stable, which is why eye doctors often suggest waiting until your levels have been steady for a while before updating a glasses prescription.

Is Blurry Vision a Sign of Diabetes?

It can be. Blurry vision that comes and goes is sometimes one of the first signs that leads people to discover they have diabetes, especially alongside increased thirst, frequent urination, fatigue or unexplained weight loss. If that sounds familiar, see your primary care doctor for a blood sugar check, and see an eye doctor to rule out other causes of blurry vision.

Why Early Diabetic Eye Disease Often Has No Symptoms

The biggest challenge with diabetic eye disease is how quiet it can be. Retinopathy can be well underway while your vision still seems perfectly clear, because the early changes often happen away from the center of the retina. Many people are surprised to learn they have retinopathy at a routine exam.

That’s why waiting for symptoms is risky. By the time diabetic eye disease affects your vision, it’s often more advanced and harder to treat.

Symptoms That Need Prompt Care

As diabetic eye disease progresses, you may notice:

Blurry or fluctuating vision
New spots, dark strings or floaters in your vision
Dark or empty areas in your central vision
Straight lines that look wavy or distorted
Trouble seeing at night
Colors that appear faded or washed out

If you have diabetes and notice any of these, schedule an eye exam soon rather than waiting for your next routine visit.

Seek care the same day, or go to an emergency room if you can’t reach an eye doctor, if you have a sudden loss of vision, a sudden shower of new floaters, flashes of light, or a curtain or shadow moving across your vision. These can be signs of bleeding inside the eye or a retinal detachment, which need urgent treatment.

How Often Should You Get a Diabetic Eye Exam?

Most people with diabetes should have a comprehensive dilated eye exam at least once a year, even if their vision seems fine. Your eye doctor may recommend more frequent visits if you already have signs of diabetic eye disease. Current guidelines generally advise:

Type 2 diabetes: an eye exam at the time of diagnosis, since the disease may have been present for a while before it was found
Type 1 diabetes: a first eye exam within about five years of diagnosis
Pregnancy: people with type 1 or type 2 diabetes who become pregnant should have an eye exam before pregnancy or early in the first trimester, because retinopathy can progress during pregnancy

What Happens During a Diabetic Eye Exam?

Your eye doctor places drops in your eyes to widen (dilate) your pupils, which allows a clear view of the retina, the macula and the optic nerve. Retinal photos or a scan called optical coherence tomography (OCT), which creates detailed cross-section images of the retina, may be used to look for swelling and track changes from year to year. The exam also checks your eye pressure and the lens for signs of glaucoma and cataracts. Dilation can make your vision blurry and light-sensitive for a few hours, so bring sunglasses and consider having someone drive you.

Both optometrists and ophthalmologists perform diabetic eye exams and monitor your eyes over time, and they can share results with your primary care doctor or endocrinologist so your whole care team stays informed. See our diabetic eye care services for what a visit with us includes.

How to Lower Your Risk of Diabetic Eye Disease

You have more control than you might think. Steps that help protect your eyes include:

Keep your blood sugar in your target range. Steady control slows damage to the retina’s blood vessels. Work with your doctor on the right targets for you.
Manage blood pressure and cholesterol. Both affect the health of the blood vessels in your eyes.
Don’t smoke, or get help quitting if you do.
Stay active and follow a healthy eating plan.
Take your medications as prescribed.
Keep every eye appointment, even when your vision feels normal.
Report vision changes right away instead of waiting to see if they pass.

Good control lowers your risk significantly, but it doesn’t remove it, so yearly exams still matter even if your numbers look great.

How Is Diabetic Eye Disease Treated?

Treatment depends on the type and stage of eye disease:

Monitoring and better blood sugar control: In early stages, careful follow-up along with improved blood sugar, blood pressure and cholesterol control may be all that’s needed.
Eye injections: Medications injected into the eye can reduce swelling in the macula and slow the growth of abnormal blood vessels. They are usually given as a series of treatments over time.
Laser treatment: Laser can seal leaking blood vessels or shrink abnormal vessel growth to help protect the retina.
Vitrectomy surgery: In advanced cases with bleeding or scar tissue, surgery can remove blood from the vitreous gel and repair damage.
Cataract surgery: If a cataract is clouding your vision, removing it can restore clearer sight. Your doctor will usually want any retinopathy or macular swelling under control first.

These treatments can stabilize vision and, in some cases, improve it. They work best when problems are found early. Injections, laser and surgery are performed by ophthalmologists, and ongoing treatment often involves regular visits for imaging and follow-up. Learn more about our retinal care services.

Diabetic Eye Care Close to Home in East Tennessee

Diabetic eye care is a long-term commitment, with yearly exams and sometimes ongoing treatment, and that’s much easier to keep up with when your eye doctor is nearby. Tennessee Eye Care provides diabetic eye exams and retinal care at our clinics in Harriman, Knoxville, Lenoir City, Morristown and Powell.

If you have diabetes and haven’t had a dilated eye exam in the past year, or if you’ve noticed any change in your vision, don’t wait. Find the clinic nearest you and schedule your diabetic eye exam.