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Prevent diabetes problems

Keep your eyes healthy

Number

4in a

Series

of 7

National Diabetes Information

Clearinghouse

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Prevent diabetes problems:

Keep your eyes healthy

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Contents

Whatarediabetesproblems?..................................1

WhatshouldIdoeachdaytostayhealthy withdiabetes?...........................................................2

WhatcanIdotopreventdiabeteseyeproblems?...........................................................3

Howcandiabeteshurtmyeyes?.............................4 Howcandiabeteshurttheretinasofmyeyes?................................................................5

Whathappensasdiabetesretinaproblemsgetworse?.................................................................6

WhatcanIdoaboutdiabetesretinaproblems?.......................................................8

HowdoIknowifIhaveretinadamagefromdiabetes?..........................................................9

Whatothereyeproblemscanhappen

topeoplewithdiabetes?........................................10

PronunciationGuide..............................................11

ForMoreInformation...........................................12

MoreintheSeries..................................................15

Acknowledgments..................................................16

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What are diabetes problems?

Toomuchglucoseinthebloodforalongtimecancausediabetesproblems. Thishighbloodglucose,alsocalledbloodsugar,candamagemanypartsofthebody,suchastheheart,bloodvessels,eyes,andkidneys. Heartandbloodvesseldiseasecanleadtoheartattacksandstrokes. Youcandoalottopreventorslowdowndiabetesproblems.

Thisbookletisabouteyeproblemscausedbydiabetes. Youwilllearnthethingsyoucandoeachdayandduringeachyeartostayhealthyandpreventdiabetesproblems.

Optic nerve

Vitreous

Blood vessels

on retina

Retina

Lens

Highbloodglucosecancauseeyeproblems.

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What should I do each day to stayhealthy with diabetes?

Followthehealthyeatingplanthat youandyourdoctorordietitianhave workedout.

Beactiveatotalof30minutesmost

days. Askyourdoctorwhatactivitiesarebestforyou.

Takeyourmedicinesasdirected.

Checkyourbloodglucoseeveryday.

Eachtimeyoucheckyourbloodglucose,writethenumberinyourrecordbook.

Checkyourfeeteverydayforcuts,blisters,sores,swelling,redness,or

soretoenails.

Brushandflossyourteetheveryday.

Controlyourbloodpressureandcholesterol.

Don’tsmoke.

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What can I do to prevent diabeteseye problems?

Youcandoalottopreventdiabeteseyeproblems.

● Keepyourbloodglucoseandbloodpressureasclosetonormalasyoucan.

● Haveaneyecareprofessionalexamineyoureyesonceayear. HavethisexamevenifyourvisionisOK. Theeyecareprofessionalwillusedropstomaketheblackpartofyoureyes—pupils—bigger. Thisprocessiscalleddilating*

yourpupil,whichallowstheeyecareprofessional

toseethebackofyoureye. Findingeyeproblemsearly andgettingtreatmentrightawaywillhelppreventmoreseriousproblemslateron.

*Seepage11fortipsonhowtosaythewordsinboldtype.

Dilatedeye.

Undilatedeye.

● Askyoureyecareprofessionaltocheckforsignsofcataractsandglaucoma. Seepage10tolearnmoreaboutcataractsandglaucoma.

● Ifyouareplanningtogetpregnantsoon,ask yourdoctorifyoushouldhaveaneyeexam.

● Ifyouarepregnantandhavediabetes,seeaneyecareprofessionalduringyourfirst3monthsofpregnancy.

● Don’tsmoke.

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How can diabetes hurt my eyes?

Highbloodglucoseandhighbloodpressurefromdiabetescanhurtfourpartsofyoureye:

● Retina. Theretinaistheliningatthebackoftheeye. Theretina’sjobistosenselightcomingintotheeye.

● Vitreous. Thevitreousisajelly-likefluidthatfillsthebackoftheeye.

● Lens. Thelensisatthefrontoftheeye. Thelensfocuseslightontheretina.

● Optic nerve. Theopticnerveistheeye’smainnervetothebrain.

Optic nerve

Vitreous

Blood vessels

on retina

Retina

Lens

Asideviewoftheeye.

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How can diabetes hurt the retinasof my eyes?

Retinadamagehappensslowly.Yourretinashavetinybloodvesselsthatareeasytodamage. Havinghighbloodglucoseandhighbloodpressureforalongtimecandamagethesetinybloodvessels.

First,thesetinybloodvesselsswellandweaken.

Somebloodvesselsthenbecomecloggedanddonotletenoughbloodthrough. Atfirst,youmightnothaveanylossofsightfromthesechanges.Haveadilatedeyeexamonceayearevenifyoursightseemsfine.

Oneofyoureyesmaybedamagedmorethantheother. Orbotheyesmayhavethesameamountofdamage.

Diabeticretinopathyisthemedicaltermforthemostcommondiabeteseyeproblem.

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What happens as diabetes retinaproblems get worse?

Asdiabetesretinaproblemsgetworse,newblood vesselsgrow. Thesenewbloodvesselsareweak.Theybreakeasilyandleakbloodintothevitreousofyoureye. Theleakingbloodkeepslightfromreachingtheretina.

Youmayseefloatingspotsoralmosttotaldarkness. Sometimesthebloodwillclearoutbyitself. Butyoumightneedsurgerytoremoveit.

Overtheyears,theswollenandweakblood vesselscanformscartissueandpulltheretina

awayfromthebackoftheeye. Iftheretinabecomesdetached,youmayseefloatingspotsorflashinglights.

Youmayfeelasifacurtainhasbeenpulledoverpartofwhatyouarelookingat. Adetachedretinacancauselossofsightorblindnessifyoudon’ttakecareofitrightaway.

Callyoureyecareprofessionalrightawayifyouarehavinganyvisionproblemsorifyouhavehadasuddenchangeinyourvision.

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Optic nerve

Vitreous

Blood vessels

on retina

Retina

Lens

Aretinawithoutanydamage.

Lens Optic nerve

Blood vessels

on retina

Retina

Vitreous

Aretinawithsomediabetesdamage.

New blood vessels

Lens

Optic nerve

Blood vessels

on retina

Vitreous

Retina

Aretinawithalotofdiabetesdamage.

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What can I do about diabetesretina problems?

Keepyourbloodglucoseandbloodpressureasclosetonormalasyoucan.

Youreyecareprofessionalmaysuggestlasertreatment,whichiswhenalightbeamisaimedintotheretinaofthedamagedeye. Thebeam

closesoffleakingbloodvessels. Itmaystopbloodandfluidfromleakingintothevitreous. Lasertreatmentmayslowthelossofsight.

Ifalotofbloodhasleakedintoyourvitreousand yoursightispoor,youreyecareprofessionalmight

suggestyouhavesurgerycalleda vitrectomy. A vitrectomyremovesbloodandfluidfromthe vitreousofyoureye. Thencleanfluidisputbackintotheeye. Thesurgerycanmakeyoureyesightbetter.

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How do I know if I have retinadamage from diabetes?

Youmaynothaveanysignsofdiabetesretinadamage,oryoumayhaveoneormoresigns:

● blurryordoublevision

● rings,flashinglights,orblankspots

● darkorfloatingspots● painorpressureinoneorbothofyoureyes

● troubleseeingthingsoutofthecornersof youreyes

Normalvision Blurryvision

Ifyouhaveretinadamagefromdiabetes,youmayhave

blurryordoublevision.

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What other eye problems canhappen to people with diabetes?

Youcangettwoothereyeproblems—cataractsandglaucoma. Peoplewithoutdiabetescangettheseeyeproblems,too. Butpeoplewithdiabetesgettheseproblemsmoreoftenandatayoungerage.

● Acataractisacloudoverthelensofyoureye,

whichisusuallyclear. Thelensfocuseslightontotheretina. Acataractmakeseverything

youlookatseemcloudy. Youneedsurgerytoremovethecataract. Duringsurgeryyourlensistakenoutandaplasticlens,likeacontactlens,isputin. Theplasticlensstaysinyoureyeallthetime. Cataractsurgeryhelpsyouseeclearlyagain.

● Glaucomastartsfrompressurebuildingupintheeye. Overtime,thispressuredamagesyoureye’smainnerve—theopticnerve. Thedamagefirst

causesyoutolosesightfromthesidesofyoureyes. Treatingglaucomaisusuallysimple.Youreyecareprofessionalwillgiveyouspecialdropstouseeverydaytolowerthepressureinyoureyes. Oryoureyecareprofessionalmaywant

youtohavelasersurgery.

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Pronunciation Guide

cataracts(KAT-uh-rakts)

dilating(DY-layt-eeng)

glaucoma(glaw-KOH-muh)

lens(lenz)

optic nerve (AHP-tik)(nerv)

retina(RET-ih-nuh)

retinopathy(RET-ih-NOP-uh-thee)

vitrectomy(vih-TREK-tuh-mee)

vitreous(VIT-ree-uhss)

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For More Information

Eye Care Professionals(ophthalmologists,optometrists)

Tofindaneyecareprofessionalnearyou,askyourdoctorforarecommendation,contactanearbyhospital

ormedicalschool,orcallastateorcountyassociationofophthalmologistsoroptometrists.

SeetheAmericanAcademyofOphthalmology

websiteat www.aao.org andusethe“FindanEyeM.D.”service.

SeetheAmericanOptometricAssociation websiteat www.aoa.org andclickon“FindanOptometrist”orcall1–800–365–2219.

Diabetes Teachers(nurses,dietitians,pharmacists,andotherhealthprofessionals)

Tofindadiabetesteachernearyou,callthe AmericanAssociationofDiabetesEducatorstoll-freeat1–800–TEAMUP4(832–6874),orlookontheInternetat www.diabeteseducator.org

andclickon“FindaDiabetesEducator.”

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Dietitians

Tofindadietitiannearyou,contacttheAmerican

DieteticAssociationat www.eatright.org andclickon“FindaNutritionProfessional.”

Government

TheNationalEyeInstitute(NEI)ispartoftheNationalInstitutesofHealth. Tolearnmore

abouteyeproblems,writeorcalltheNEI,2020VisionPlace,Bethesda,MD20892–3655,301–496–5248;orsee www.nei.nih.govontheInternet.

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Togetmoreinformationabouttakingcareofdiabetes,contact

National Diabetes Information Clearinghouse1InformationWay Bethesda,MD 20892–3560 Phone: 1–800–860–8747 TTY: 1–866–569–1162 Fax:703–738–4929

Email: [email protected] Internet: www.diabetes.niddk.nih.gov

National Diabetes Education Program

1DiabetesWay Bethesda,MD 20814–9692

Phone: 1–888–693–NDEP(6337) TTY: 1–866–569–1162 Fax:703–738–4929 Email: [email protected] Internet: www.ndep.nih.gov

American Diabetes Association

1701NorthBeauregardStreet Alexandria,VA22311 Phone: 1–800–DIABETES(342–2383) Internet: www.diabetes.org

Juvenile Diabetes Research Foundation

International

120WallStreet NewYork,NY10005–4001 Phone: 1–800–533–CURE(2873) Internet: www.jdrf.org

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More in the Series

The“PreventDiabetesProblems”Serieshasseven

bookletsthatcanhelpyoulearnmoreabouthowtopreventdiabetesproblems.

Forfreesinglecopiesofthesebooklets,write,call,

fax,oremailtheNationalDiabetesInformationClearinghouse1InformationWayBethesda,MD 20892–3560Phone: 1–800–860–8747TTY: 1–866–569–1162

Fax:703–738–4929Email: [email protected]

Thesebookletsarealsoavailableat www.diabetes.niddk.nih.gov ontheInternet.

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Acknowledgments

TheNationalDiabetesInformationClearinghousethanksthepeoplewhohelpedrevieworfield-testthispublication:

For the American

Association of

Diabetes Educators

LynnGrieger,R.D.,C.D.E.

Arlington,VTCeliaLevesque,R.N.,

C.D.E.Montgomery,ALTeresaMcMahon,

Pharm.D.,C.D.E.Seattle,WABarbaraSchreiner,R.N.,

M.N.,C.D.E.

Galveston,TX For the American

Diabetes Association

PhyllisBarrier,M.S.,R.D.,C.D.E.

Alexandria,VALindaHaas,Ph.C.,R.N.,

C.D.E.Seattle,WA

KathleenMahoney,M.S.N.,R.N.,C.D.E.DrexelHill,PARandiKington,M.S.,

R.N.,C.S.,C.D.E.Hartford,CT

For the Centers for

Medicare & Medicaid

Services

Baltimore,MD JanDrass,R.N.,C.D.E.

For the Diabetes Research

and Training Centers

AlbertEinsteinSchoolofMedicine

NorwalkHospital

Norwalk,CTJillEly,R.N.,C.D.E.SamEngel,M.D.PamHoward,A.P.R.N.,

C.D.E.

IndianaUniversitySchoolofMedicine

Indianapolis,INMadelynWheeler,M.S.,

R.D.,F.A.D.A.,C.D.E.

VA/JDFDiabetesResearchCenter

VanderbiltSchoolofMedicine

Nashville,TNOkChonAllison,

M.S.N.,R.N.C.S., A.N.P.,C.D.E.

BarbaraBacker,B.S.JamesW.Pichert,Ph.D. AlvinPowers,M.D.MelissaE.SchweikhartMichaelB.SmithKathleenWolffe,R.N.

For the Grady Health

System Diabetes Clinic

Atlanta,GA

ErnestineBaker,R.N., F.N.P.,C.D.E.

KrisErnst,R.N.,C.D.E.MargaretFowke,

R.D.,L.D.KayMann,R.N.,C.D.E.

For the Indian Health

Service

Albuquerque,NM RuthBear,R.D.,C.D.E. DorindaBradley,R.N.,

C.D.E.TerryFisher,R.N.LorraineValdez,R.N.,

C.D.E.

RedLake,MNCharmaineBranchaud,

B.S.N.,R.N.,C.D.E.

For the Medlantic

Research CenterWashington,DCResaLevetan,M.D.

For the National Eye

Institute

JudithSteinBethesda,MD

For the Texas Diabetes

CouncilTexasDepartmentofHealth

Austin,TXLubyGarza-Abijaoude,

M.S.,R.D.,L.D.

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National DiabetesInformation Clearinghouse

1InformationWay Bethesda,MD 20892–3560 Phone: 1–800–860–8747 TTY: 1–866–569–1162 Fax:703–738–4929 Email: [email protected] Internet: www.diabetes.niddk.nih.gov

TheNationalDiabetesInformationClearinghouse(NDIC)isaserviceoftheNationalInstituteofDiabetesandDigestiveandKidneyDiseases(NIDDK). TheNIDDKispartoftheNationalInstitutesofHealthoftheU.S.DepartmentofHealthandHumanServices. Establishedin1978,theClearinghouseprovidesinformationaboutdiabetestopeoplewithdiabetesandtotheirfamilies,healthcareprofessionals,andthepublic. TheNDICanswersinquiries,developsanddistributespublications,andworkscloselywithprofessionalandpatientorganizationsandGovernmentagenciestocoordinateresourcesaboutdiabetes.

PublicationsproducedbytheClearinghousearecarefullyreviewedbybothNIDDKscientistsandoutsideexperts.

Thispublicationisnotcopyrighted. TheClearinghouseencouragesusersofthisbooklettoduplicateanddistributeasmanycopiesasdesired.

Thisbookletisalsoavailableat www.diabetes.niddk.nih.gov.

Thispublicationmaycontaininformationaboutmedications.Whenprepared,thispublicationincludedthemostcurrentinformationavailable. Forupdatesorforquestionsaboutanymedications,contacttheU.S.FoodandDrugAdministrationtoll-freeat1–888–INFO–FDA(463–6332)orvisit www.fda.gov.Consultyourdoctorformoreinformation.

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NIH Publication No. 09–4279

No ember 2008

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