Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million. 

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.  

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring. 

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes. 

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy. 

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness. 

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages. 

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy. 

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision. 

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss. 

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids. 

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes. 

While we all know that regular eye exams can help detect warning signs of disease and prevent vision loss, many people fail to seek medical attention when there is an acute problem with the eye. In fact, only about half of Americans that are at risk for serious vision loss have been examined by an eye doctor within the last year, according to a report by the Centers for Disease Control and Prevention. 

While it’s true that some eye symptoms resolve on their own, it’s better not to take the chance when your eyesight is at risk. Here are seven eye symptoms that should be checked out by an eye doctor immediately, as they could indicate a serious underlying condition that could threaten your vision. Remember, even if you think the issue is minor, getting proper medical attention could be vital to saving your vision. 

1. Frequent Floaters

   Floaters are shadows or spots that appear to float through your field of vision, particularly when you are looking at a solid colored or bright background such as the blue sky or a white wall. They can appear in a variety of shapes such as a shower of dots or mosquito shaped for example. It is common to see floaters on occasion, however if you experience a sudden increase, especially in combination with pain, flashes or loss of peripheral vision, you should see a doctor immediately. Flashes of light may appear as a quick spark or jagged streaks of light or arcs among other shapes. This could be a sign of a very serious problem such as detached or torn retina, a hemorrhage or bleeding inside the eye, an inflammation of the vitreous or retina caused by an infection or injury or an eye tumor. In the case of a retinal detachment, the different pattern of floaters or flashes depend on how the retina tears, so if you suddenly notice a distinct pattern of floaters or light in your vision, don’t delay: seek medical attention within 24 hours. 

2. Persistent Redness or Irritation

   While minor redness can simply be a result of allergies, exhaustion or extended contact lens wear, there are some more serious causes of eye redness, especially if it persists or is accompanied by pain, swelling, discharge, vision disturbance or severe itchiness. Along with conjunctivitis (or pink eye) which can be a very contagious eye infection, redness can indicate a corneal scratch, uveitis or glaucoma. 

3. Excessive Watery Eyes 

   Whether you have a foreign object in your eye or are experiencing dryness due to allergies or environmental factors, eye watering is a natural response to keep your eyes healthy, comfortable and safe. When it is constant and disruptive, however, this is no longer normal. Excessive eye watering could indicate a chronic condition such as dry eye syndrome, tear duct problems or problems with the cornea such as a scratch or an ulcer.

4. Foreign Body in the Eye

   If you experience a foreign object in your eye, the first thing to do it try to flush it out. Never rub the eye as it could cause even greater damage. If your efforts to flush the object out are not successful it is time to see a doctor. Additionally, if you are experiencing vision disturbances, pain or redness while the object is there or after you think you have removed it, see an eye doctor immediately. 

5. Ptosis (Droopy Eyelid) 

   Ptosis or drooping eyelids is seen in one or both eyelids and can be caused by benign conditions such as allergies or merely part of the aging process. Nevertheless, it can also be a sign of a serious condition such as nerve damage, a stroke, brain tumor or a condition called myasthenia gravis, which is a neurological condition that affects the muscles of the eye. It is also sometimes a result of eye surgery or injury. Often ptosis will resolve gradually on its own, however it is something that should be checked out, especially if it occurs suddenly, to ensure there is no serious underlying cause. 

6. Bleeding Eyes 

   A subconjunctival hemorrhage in the eye is when a blood vessel right under the surface of the eye breaks. You will see that the white part or sclera of the eye has turned red. Usually, this common occurrence is nothing to be concerned about as this can happen from something as simple as straining, a sneeze or cough. In this case there is nothing to do and it will resolve on its own. If however, the redness comes after an injury to your eye or head it could indicate that there is bleeding in the brain and should be examined immediately.

7. Moderate to Severe Eye Pain 

   There are several causes of eye pain, the most serious of which is acute angle closure glaucoma or uveitis. Other causes of pain can include corneal abrasions and ulcers, scleritis, orbital cellulitis and sinusitis. 

When it comes to problems with the eye, it’s always best to err on the side of caution and get them checked out. Doing otherwise, could cost you your eyesight. Your eye doctor can help.

What’s it like to be color blind? Contrary to what the name implies, color blindness usually does not actually mean that you don’t see any color, but rather that you have difficulty perceiving or distinguishing between certain colors. This is why many prefer the term color vision deficiency or CVD to describe the condition. CVD affects men more than women, appearing in approximately 8% of men (1 in 12) and .5% of women (1 in 200) worldwide. 

Having color vision deficiency means that you perceive color in a more limited way than those with normal color vision. This ranges from mild, in which you may not even be aware that you are experiencing color differently, to severe, which is perhaps the more appropriate from to be called “color blind” and involves the inability to see certain colors. 

CVD can be inherited; it is caused by abnormalities in the genes that produce photopigments located in the cone cells in your eyes. The eyes contain different cone cells that fire in response to a specific color, blue, green or red and together allow you to see the depth and range of colors that the normal eye can see. The type of color blindness and therefore the type of color vision that is impaired, is based on which photopigments are abnormal. The most common form of CVD is red-green, followed by blue-yellow. Total color blindness or the complete inability to perceive color is quite rare. About 7% of males have congenital color blindness that they inherit from the mother’s X-chromosome. 

Color blindness can also be the result of eye damage, specifically to the optic nerve, or to the area in the brain that processes color. Sometimes an eye disease, such as cataracts, can also impact one’s ability to perceive color. Systemic diseases such as diabetes or multiple sclerosis can also cause acquired CVD. 

Living with CVD

Red-green color blindness does not mean only that you can’t tell the difference between red and green, but rather that any color that has some red or green (such as purple, orange, brown, pink, some shades of gray, etc) in it is affected. 

You many not realize all of the ways you use even subtle distinctions in color in your daily life. Here are some examples of ways that CVD can impact your life and make seemingly everyday tasks challenging:

• You may not be able to cook meat to the desired temperature based on color. 
• Most of the colors in a box of crayons will be indistinguishable.
• You may not be able to distinguish between red and green LED displays on electronic devices that indicate power on and off. 
• You may not be able to tell between a ripe and unripe fruit or vegetable such as bananas (green vs. yellow) or tomatoes (red vs green). 
• Chocolate sauce, barbecue sauce and ketchup may all look the same. 
• Bright green vegetables can look unappealing as they appear greenish, brown or grey. 
• You may not be able to distinguish color coded pie charts or graphs (which can cause difficulty in school or work). 
• Selecting an outfit that matches can be difficult. 

Knowing that one is color blind is important for some occupations that require good color discrimination such as the police officers, railway workers, pilots, electricians etc.  These are just a few of the ways that CVD can impact one’s daily life. So is there a cure? Not yet. 

While there is no cure for CVD, there is research being done into gene therapies and in the meantime there are corrective devices available including color vision glasses (such as the Enchroma brand) and color filtering contacts that for some can help to enhance color for some people. If you think you might have CVD, your optometrist can perform some tests to diagnose it or rule it out. If you have CVD, you can speak to your eye doctor about options that might be able to help you experience your world in full color. 

On August 21st, for the first time since 1979, a solar eclipse will be visible across North America. What’s even more historic is that it will also be the first time an eclipse will be visible across the continent, from coast to coast, since 1918. If you want to bear witness to this historic event, it is important to do so safely which means being knowledgeable about the event and prepared to protect your eyes from potential serious damage and vision loss.

First of all, here are the facts about the upcoming eclipse. A total solar eclipse is when the moon completely blocks the face of the sun (called the photosphere) leaving only the sun’s outer ring, called the corona, in view. This event happens briefly, and will only be visible for certain parts of the United States for up to two minutes and forty seconds during the upcoming celestial event. All of North America, including mainland US and Canada, however, will be able to view a partial eclipse for the duration of about two to three hours. You can search online to see which part of the eclipse will be visible from your location and what time you will be able to see it.

With 500 million people in the viewing range of the eclipse, thousands are excitedly preparing for what could be for many a once-in-a-lifetime experience, however, it’s crucial to make sure that this is done safely to protect your eyes and vision from serious damage that can occur from viewing an eclipse without proper eye protection.

Looking at a Solar Eclipse

Viewing a solar eclipse without proper eye protection is extremely dangerous and can cause permanent vision loss. Looking directly at the sun can cause a condition called Solar Retinopathy or retinal burns which can cause damage to and destroy cells in the retina, which communicates visual cues with the brain. It can also burn the macula which is responsible for central vision. While we usually have a hard time looking directly at the sun which helps to protect us from this condition, during an eclipse because the sun is partially covered by the moon, looking directly at the sun becomes less difficult. Nevertheless, the exposure to the damaging rays of the sun is just as strong and therefore the risk just as great.

It’s important to note that solar burns to the retina do not cause symptoms during that time that you are looking at the eclipse. There is no pain or discomfort. However, the longer you look at it, the deeper the hole that burns through the retina and you would not notice the vision loss until hours later. There is no treatment for solar retinopathy. Many will notice recovery in vision, but depending on the severity of damage there may be only partial recovery which may take up to 6 months after viewing the eclipse.

Eclipse Glasses: Solar Eclipse Eye Protection

Do not view the eclipse without proper eye protection. Protecting your eyes during an eclipse with specially designed eyewear or solar viewers is a must. The American Optometric Association and NASA have released the following statement regarding eye protection: “There is only one safe way to look directly at the sun, whether during an eclipse or not: through special-purpose solar filters. These solar filters are used in “eclipse glasses” or in hand-held solar viewers. They must meet a very specific worldwide standard known as ISO 12312-2.”

It’s important to note that regular sunglasses are not sufficient in protecting your eyes. Here are some additional safety tips issued by NASA for viewing the eclipse:

• Stand still and cover the eyes with eclipse glasses or solar viewer before looking up at the bright sun. After glancing at the sun, turn away and remove the filter—do not remove it while looking at the sun.
• Do not look at the un-eclipsed or partially eclipsed sun through an unfiltered camera, telescope, binoculars or other optical device. Similarly, do not look at the sun through a camera, a telescope, binoculars, or any other optical device while using your eclipse glasses or hand-held solar viewer—the concentrated solar rays will damage the filter and enter your eye(s), causing serious injury.
• If you are within the path of totality, remove your solar filter only when the moon completely covers the sun’s bright face and it gets quite dark.

If you plan to view the eclipse, make sure that you plan ahead and obtain eclipse glasses or solar viewers for every person that plans to enjoy the experience. Keep this once in a lifetime experience a safe and enjoyable one.

To obtain eclipse glasses, contact your local optometrist, or visit the American Optometry Association website for more information.

Light sensitivity, also known as photophobia, is a condition in which bright light – either natural sunlight or artificial light –  can cause significant discomfort, pain and intolerance. People that experience light sensitivity will find themselves needing to close their eyes or squint when exposed to light and often experience headaches and nausea as well.  In mild cases, the discomfort accompanies exposure to bright lights or harsh sunlight, but in severe cases even a small amount of light can cause pain and discomfort.  

Photophobia is more common in individuals with light eyes. This is because the greater amounts of pigment in darker eyes help to protect the eye from the harsh rays of light. The darker pigment of the iris and choroid absorbs the light, rather than reflecting the light and causing internal reflection or glare experienced by those with lighter eyes. People with albinism, which is a total lack of eye pigment, also experience significant light sensitivity for this reason. 

Acute photophobia is usually a symptom that accompanies a condition such as an eye infection or irritation (such as conjunctivitis or dry eyes), a virus, or a migraine (light sensitivity is one of the most common symptoms of migraines). It could also be caused by something more serious such as an eye condition like a corneal abrasion, a detached retina, uveitis or iritis or a systemic disease like meningitis or encephalitis. Light sensitivity is also a side effect of refractive surgery (such as LASIK) and some medications (such as tetracycline and doxycycline).  

How to Deal with Photophobia

The most effective way to reduce the discomfort caused by photophobia is to stay out of sunlight and dim indoor lights as much as possible while you are experiencing symptoms. Wearing dark sunglasses and keeping your eyes closed may also provide some relief. 

In the summer it is more common for UV to trigger corneal inflammation (keratitis) and cause photosensitivity as well. Wind and eye dryness can also set off photosensitivity, which are more good reasons to wear sunglasses. 

If the sensitivity is new and the cause is unknown, you should seek medical attention immediately, especially if you experience any of the following symptoms:  

• Blurry vision
• Burning or pain in the eye
• Fever and chills
• Confusion and irritability
• Severe headache
• Drowsiness
• Stiff neck
• Nausea and vomiting
• Numbness
• Foreign body sensation

In cases where the photophobia is a symptom of an underlying issue, treating the issue will likely cause relief in your sensitivity. This will vary depending on the ailment but could include pain medications, eye drops or antibiotics, or anti-inflammatory medications. If the sensitivity is mild due to your genetic predisposition or a result of surgery, make sure you take your sunglasses every time you leave the house. People who wear prescription eyeglasses may consider photochromic lenses which automatically darken when exposed to light. 

If you are uncomfortable, speak to your eye doctor about the best options for your condition.  

What Exactly Is a Black Eye?

A black eye, also known as a periorbital hematoma, is usually not an injury of the actual eye (which is why it is called “periorbital”- around the eye). It typically occurs when there is an injury to the face or the eye socket which causes bleeding beneath the skin and bruising. The term, “black eye” comes from the dark coloring of the bruising that occurs underneath the skin around the eye.

When a blunt force hits the eye socket, this can cause capillaries in the area to burst, causing hemorrhaging, also known as a hematoma. This blood can accumulate in the eye socket and as it begins to be reabsorbed into the surrounding tissues, the colors of the bruising begin to change. That’s why you will often notice the coloring of the black eye to go from a dark purplish-red color to brownish and then yellow. 

Sometimes along with the external bruising, you might also notice a small amount of bleeding on the white surface of the eye, which is called a subconjunctival hemorrhage. This is when the tiny blood vessels on the white sclera are broken and leak blood. It’s generally harmless but sometimes looks scarier to the patient than the black eye does. This condition will also reabsorb on its own and is nothing to be concerned about. 

While most black eyes can look pretty serious due to the dramatic color, an uncomplicated black eye will typically heal within a week to ten days. If it doesn’t, there could be a more serious issue such as a bone fracture or an orbital blowout fracture.This could present with restricted eye movement, especially if looking up or down, and numbness of the cheek and/or upper lip on the same side as the black eye. The eye may even appear sunken in. Further, if there is bleeding within the actual eye (called a hyphema) or floaters or flashes in the vision, then it is definitely advisable to see your eye doctor as soon as possible. These could be signs of more serious damage such a corneal or retinal damage and can lead to vision loss. 

Treatment for a Black Eye

Usually, the best treatment for a black eye is to apply a cold compress (or even better, a bag of frozen vegetables, which is more flexible and can conform to the contours of the face) directly on the area. The cold will reduce swelling and constrict capillaries to reduce internal bleeding as well. Apply the cold for about 15-20 minutes every hour.  If there is pain, over the counter pain medications can help. 

If however, you experience any of the following symptoms, you should seek medical attention:

• Blood on the surface of the eye or a visible incision on the eye
• Vision changes such as double vision, blurred vision, loss of vision or the appearance of floaters
• Loss of consciousness, dizziness or fainting
• Loss of eye movement
• Persistent headaches
• Blood or fluids coming from the ears or nose
• Vomiting
• Signs of infection such as excessive swelling, pus, redness or a fever
• Severe pain

In addition to blunt trauma, black eyes can be caused by sinus infections, nasal or eye surgery or other infections in the area such as the teeth infections or cellulitis (a serious infection that can occur around the eyes). A skull fracture can also cause both eyes to turn black, sometimes known as raccoon eyes. 

Unless you notice any severe symptoms you can rest assured that your black eye is a bruise just like anywhere else on the body and with a little care, rest and patience, it will clear up in no time.