8 Tips to Prevent Diabetic Retinopathy

Medically reviewed by Danielle Weiss, MD

Diabetic retinopathy is a common complication of diabetes (including type 2 diabetes) that causes vision problems. By controlling your blood sugar, blood pressure, and cholesterol, you can reduce your risk of vision loss due to diabetes.

This article will provide eight tips to help keep your eyes healthy when you have type 2 diabetes and prevent diabetic retinopathy.

Get Your Eyes Checked Regularly

High blood sugar can damage blood vessels, including the ones in your eyes. If the blood vessels start to leak, it can harm your vision. The resulting condition, called diabetic retinopathy, can be halted or sometimes improved, but it's important to catch it early.

Stay up on appointments to check your vision because the early stages of diabetic retinopathy often have no symptoms. Have a professional eye exam at least once a year with an ophthalmologist or optometrist (eye doctor) who is experienced with diagnosing diabetic retinopathy.

If your healthcare provider suggests you come more often, follow their recommendation.

What Is Included in a Compete Eye Exam?

A complete eye exam includes taking a picture of your retina (the light-sensing layer at the back of the eye) with a tool called an ophthalmoscope. The optometrist will dilate your pupils first with eyedrops, which may sting slightly.

When your pupils are dilated, which takes about 20 minutes, a healthcare provider uses the scope to take pictures of your retina, looking for any damage.

You'll also have an acuity test, which is the one where you read the lines on a chart. Your optometrist will also ask you about any vision changes you've noticed. A complete eye exam can sometimes reveal damage even before it affects your vision.

Tell Your Healthcare Provider About Vision Changes

Tell your healthcare provider if you notice any changes in your vision, like dark spots, blurriness, or "holes" in your eyesight. The earlier your healthcare provider knows about or detects changes, the more they can do to help prevent or minimize damage.

If you see any of the following, make an appointment to see your optometrist right away, as these may indicate that the blood vessels in your eyes are leaking, which can lead to vision loss or blindness:

• Black lines or spots that don’t go away

• Red spots or red fogginess

• Any sudden changes in the clarity of your vision

• Slow adjustment seeing in the dark

Monitor Your Blood Sugar

One of the best things you can do to protect your vision (and overall health) when you have diabetes is to be vigilant about monitoring your blood sugar. When it's controlled, it's less likely to damage the lining of the blood vessels or cause new, abnormal blood vessels to grow in your eyes. Monitoring your blood sugar includes home testing and lab tests.

Home Testing

Follow your healthcare provider's recommendation on how often to check your blood sugar at home. You put a drop of blood from your finger on a test strip and place it into a glucometer (blood sugar meter) to measure it. You can use a continuous glucose monitor, but you'll still need to calibrate it using a blood sugar meter.

If you take insulin more than once a day, you may need to test several times, usually before meals and before you go to bed. If you use longer-acting insulin, you may need to test once or twice a day, before breakfast and at dinner or bedtime. However, if you manage your diabetes with diet and exercise, you may not have to test daily.

According to the Centers for Disease Control and Prevention (CDC), the target levels for blood sugar are:

• Before meals: 80 to 130 milligrams per deciliter (mg/dL) or 4.4 to 7.2 millimoles per liter (mmol/L)

• Two hours after meals: Below 180 milligrams per deciliter (10.0 millimoles per liter)

The target levels can vary according to age and other factors, so follow your healthcare provider's advice for your specific target.

Schedule Tests With Your Healthcare Provider

As long as you are not noticing vision or other health changes, you can generally go to your healthcare provider every three months for a hemoglobin A1C test. This blood test gives an average of your blood sugar levels over the last three months.

The A1C test measures the percentage of hemoglobin (the protein that carries oxygen) in your red blood cells that is coated with glucose. Your A1C result may also be reported as estimated average glucose (eAG), using the same numbers (mg/dL) as a blood sugar meter:

If your vision is stable, see your eye healthcare provider once a year. If you notice any changes in your vision or health, call them no matter when your next visit is scheduled.

Manage Your Blood Pressure

High blood pressure is common among people with type 2 diabetes. It can affect not only your cardiovascular system but also your vision.

High blood pressure affects the delicate blood vessels in your eyes. If your blood sugar is also high, the vessels may begin to leak and damage your eyesight. Keeping your blood pressure under control will reduce your risk of developing retinopathy.

Check Your Cholesterol

Your cholesterol level is another important factor in lowering the risk of diabetic retinopathy. People with type 2 diabetes and high LDL or "bad" cholesterol (and lipid levels) have a higher risk of losing vision.

Statin drugs, which treat high cholesterol, can lower the risk of developing retinopathy and improve the outlook of people who have already developed it.

Related: High Cholesterol and the Eyes: Signs and Symptoms

Follow a Healthy Diet

Eating a healthy diet has quadruple benefits for type 2 diabetes and retinopathy. Eating lean protein, fruits, and veggies will help you get to and stay at a healthy weight and manage blood sugar, blood pressure, and cholesterol levels. Each of these lowers your risk of developing retinopathy.

Exercise

Exercise is another component of getting and staying healthy when you have type 2 diabetes. Experts have noted that physically active people tended to have less severe retinopathy, unrelated to their A1C levels and body mass index (BMI). BMI is an estimate of body fat that is based on your weight and height.

Don't Smoke

The link experts see between smoking and retinopathy in type 2 diabetes has evolved. Initially, experts didn't necessarily see a connection, but now they believe that smoking increases the risk of damage to the eye's blood vessels, even when there are no symptoms.

Smoking is one of the most harmful activities to your health in general. For people with diabetes, quitting smoking will lower the chance of developing many of the complications associated with it.

Summary

Diabetic retinopathy, which damages the blood vessels in your eyes, is a common complication of type 2 diabetes. It can harm your eyesight or even cause blindness. However, there are things you can do to lower your risk of developing it.

Home and professional blood sugar testing, watching your diet, exercising, managing your blood pressure and cholesterol levels, and not smoking are key factors in lowering the chance of damaging your eyesight. Get your eyes checked once a year. Call your eye healthcare provider immediately if you notice changes in your vision.

A Word From Verywell

Diabetes can be a challenge to manage, but there are rewards to following good health principles and your diabetes team's recommendations. If you get frustrated, ensure you have the support you need if you want to vent.

Today's monitoring devices and treatments for diabetes, with some help from your behaviors, can go a long way toward reducing the risk of serious complications, including retinopathy.

Frequently Asked Questions

Can I prevent diabetic retinopathy blindness?

Advances in diabetes monitoring and treatment make it more possible than ever to control your blood sugar, which will protect your vision. A healthy lifestyle and regular eye exams will also make it less likely that you will have serious damage or vision loss.

Is it common for people with type 2 diabetes to lose their vision?

According to the CDC, diabetes is the main cause of blindness among people younger than 74, and diabetic retinopathy is the most frequent cause among people of working age.

How can you control diabetic retinopathy naturally?

An over-the-counter vitamin supplement called AREDs2 has been shown to slow down retinal changes in some people. It was studied for age-related eye disease but may also help with diabetic retinopathy.

You can also help by keeping your blood sugar under control by staying at a healthy weight and exercising.