As the incidence of diabetes continues to rise--an estimated 23.6 million Americans now have type 2 diabetes--the number of cases of eye complications is on the increase, too. In fact, the CDC projects that the number of diabetic retinopathy cases will double by 2050.

"Diabetic retinopathy is what typically occurs when a person has had diabetes for many years," explains ophthalmologist Dr. Daniel Casper of the Naomi Berrie Center for Diabetes at New York Presbyterian Hospital. "Though diabetes affects many parts of the eye, the part that can suffer the most debilitating consequences is the retina."

In diabetic retinopathy, he explains, the small blood vessels of the eye become leaky and porous. Eventually, vision is affected, although in the very early stages people have no symptoms, he says.

Who Will Develop Eye Disease?

Nearly everyone with type 1 diabetes has some form of diabetic retinopathy after 15 years, says Barbara Araneo, director of complications therapies at the Juvenile Diabetes Foundation. .

National studies have found that those who have had type 2 diabetes for 20 years stands a good chance of having some eye disease, Casper says.  Eye disease is often linked to poor blood sugar control so keeping blood sugars in the normal range is advised to prevent eye complications. "From a clinical standpoint, it is clear that many patients who have had excellent control don't develop diabetic retinopathy," Casper explains.

"As diabetic neuropathy progresses, the little amount of bleeding becomes more and more bleeding, and the blood in the eye causes scarring on the surface of the retina," Casper explains. "Over time, that scar contracts and as it does, it actually pulls the retina off the back of the eye."

Another eye condition, diabetic macular edema, causes swelling and loss of vision, Casper says.

Fortunately, there are treatments for both conditions.

Since the 1970s, the treatment for both has been laser treatments, Casper explains. "It is a remarkable treatment," he says. "And it is very effective. You may lose a little peripheral vision and have some night blindness but people retain their vision." Often, Araneo explains, steroids may be used along with laser treatments.

Newer treatments, called anti-angiogenic treatments, involves injecting certain medications directly into the eye so that they stop the growth of new blood vessels and often make the ones that have appeared actually go away.

"It is relatively painless," Casper explains. "The worst part is the anticipatory anxiety. The bad news is that these treatments don't last a long time, so if you have persistent diseases you'll need a second, third, maybe a fourth treatment."

As a treatment for diabetic macular edema, small studies around the world are looking at Avastin, a drug approved for cancer,  says Araneo.  "There is nothing consistent or conclusive yet," she says.

 The good news? "With annual eye exams and good diabetes management, you can pretty much avoid serious vision loss," she says.

Keeping your peepers in great shape:

  • If you are overweight, lose the extra pounds.
  • Try to keep your blood sugar in good control.
  • See your doctor for regular eye exams.
  • Make sure your blood cholesterol and your blood pressure are within normal limits.