You probably know that people with diabetes have trouble with blood sugar. But did you know they also have a 10% chance of developing an eye disease that can lead to blindness? If you answered “no,” you’re in good company: A study found the majority of people with diabetes have no idea their vision could be at risk.

Eyeballing the Problem
To find out if people with diabetes were getting the right vision care, researchers at Johns Hopkins University looked at data from the government’s large National Health and Nutrition Examination Survey. Alarmingly, they discovered that most people with a diabetes-related eye condition said that no doctor or healthcare provider had ever told them that diabetes was affecting their eyes. And 28% of those were already experiencing vision loss.

The study, published in the journal JAMA Ophthalmology, also found that about half of the people with diabetes hadn’t seen a health-care provider in the previous year, and two in five never had a full eye exam that included dilating the pupils.

Vision loss is an all-too common complication of diabetes. It’s caused by a condition called diabetic retinopathy, which is also the number one cause of vision loss among American adults. Up to 45% of people with diabetes have some stage of retinopathy. It happens when high blood sugar levels, along with high blood pressure, cause damage to the tiny blood vessels of the retina. The vessels start to break down and leak fluids into the surrounding eye tissue. The Hopkins study specifically looked at a type of retinopathy called diabetic macular edema, in which the part of the eye that handles sharp, straight-ahead vision swells, blurring sight and potentially leading to blindness.

Related: What causes diabetic retinopathy?

What Does Retinopathy Look Like?
There are often no symptoms, and no pain at all in the early stages of diabetic retinopathy. You can have the condition for a long time and not know it. Typically, once you notice the symptoms, significant damage has already happened.

Symptoms and complications of diabetic retinopathy include:

• Blurry or distorted vision or difficulty reading
• Seeing floating spots or “cobwebs” in your vision
• Loss of central or side vision.; seeing a shadow or veil across your field of vision
• Pain, pressure or constant redness of the eye
• Blindness

Don’t Let Diabetes Dull Your Vision

The good news is that retinopathy can be successfully treated in nearly all cases if it’s caught early. But that means regular eye exams — at least once a year by an opthalmologist or optometrist — are vital.

Related: What to Expect at an Eye Exam

Treatments for retinopathy vary depending on the type of damage to the eye and how far the condition has progressed. Laser treatments can shrink abnormal blood vessels and relieve swelling in the eye. Some people may need surgery to remove scar tissue and blood from the eyes, or repair a torn or detached retina.

As with so many things in life, an ounce of retinopathy prevention is worth a pound of cure.  Here are the top three ways to keep your vision sharp if you’ve got type 1 or type 2 diabetes:

1. Keep your blood sugar under good control and your diet healthy.
2. See an ophthalmologist or optometrist at least yearly for an eye exam, including pupil dilation.
3. Treat any signs of retina damage promptly to reduce the risk of permanent vision loss.

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