Expert Blogs | Eye Health
What You Should Know About Diabetes and Your Eyes
photo of woman having an eye exam

You’ve just been diagnosed with diabetes – or you’ve had the diagnosis for a while now – or your doctor keeps changing or adding medications because you just can’t seem to get it under control. These are common scenarios, and whether you are newly diagnosed or have had diabetes for a long time, there’s a lot of information to take in!

Diabetes is a chronic and often lifetime condition that can be gotten under control, but it takes effort and focus.

There’s no question that a healthy lifestyle is necessary, including proper dietary choices and exercise to control blood sugar. Unstable blood sugar or one that fluctuates can cause lots of changes in your body. These significant fluctuations are not good for the body and not good for your eyes.

Your doctor has likely also told you to stop smoking, keep your blood pressure under control, and get an annual dilated eye exam. These are all aimed at preventing serious problems or at least detecting them early enough to be treated. We also know that the longer you have diabetes, the more you are at risk for some serious complications.

Like the rest of the body, diabetes can affect your eyes and vision in a few ways. As your blood sugar fluctuates, diabetes can cause blurry vision and even change your eyeglass prescription. It can make you a bit more nearsighted as your sugar levels go up or more farsighted as the sugar goes down.

You may notice in your eye exam that we ask you to know your A1c because it’s a sign of your blood sugar levels over time. The goal is to have stable A1c levels with minimal fluctuation. We ask for a couple of reasons.

  • Accurate vision prescriptions. We want an accurate measurement for your eyeglass or contact lens prescription. If we think the prescription will fluctuate, we may ask you to come back for another visit when your blood sugar is better controlled. We don’t want to prescribe glasses only to have the prescription change a few weeks later.
  • Signs of possible eye damage. Research also shows that elevated A1c levels or unstable blood sugars can contribute to vascular changes in the retina, causing fragile blood vessels to leak or even causing new ones to grow. These are both signs of what’s called diabetic retinopathy or diabetic macular edema. These findings should be prevented at all costs, but if they do occur, it’s best to catch them early so that we can stop or control them before permanent damage occurs.

Cataracts can also develop earlier if you have uncontrolled diabetes. We will all get cataracts if we live long enough, but cataracts from diabetes can be more advanced. Follow your eye doctor’s recommendations for follow-up and discuss the potential for surgery when the time comes.

Glaucoma has also been shown to be at a higher rate in people with diabetes. Just because you have diabetes doesn’t mean you will get glaucoma, but the key is to have that annual comprehensive eye exam, making sure your eye pressure is measured at each visit. If you do develop glaucoma, follow your eye doctor’s recommendations with treatment and follow-up. 


For more information on diabetes and your eyes, click here.













Photo Credit:Nora Carol Photography / Moment via Getty Images

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Susan A. Primo, OD, MPH, FAAO

Susan A. Primo, OD, MPH, FAAO

Optometrist, professor, and clinician

Susan A. Primo, OD, MPH, FAAO, is professor of ophthalmology and director of optometry and vision rehabilitation services at the Emory University Eye Center in Atlanta. She has been a practicing optometrist for over 35 years. Believing that strategic public health approaches to address visual impairment and loss are desperately needed, Primo completed her MPH degree to help combat this problem. Her goal is to increase access to primary eye care services, especially in underserved communities, to reduce the burden of preventable vision loss and to improve the quality of life for those who may have lost vision.

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