December 5, 2000
Complications
Question from Jacksonville, North Carolina, USA:
My 10 year old daughter has had diabetes since age three. She wears glasses and is now experiencing problems with her eyesight again. I was told that when her blood sugar level gets better under control that her sight will improve. I am afraid that she will eventually lose her sight if not better controlled. Can the damage being done be corrected?
Answer:
So you do not worry unduly, there are a number of things to clarify. I do not know at what age your daughter first needed glasses, and if she is nearsighted or farsighted. This information would be helpful, but let me say there are three “eyesight problems” that can occur with diabetes: Vision changes due to blood sugar changes, vision change due to “natural” causes that creates the need for glasses even if she did not have diabetes, and vision changes due to actual damage to the retina.
Elevated blood sugar can cause a focus shift to mimic nearsightedness or farsightedness. Once the blood sugar is maintained in the normal range the shift will return to a person’s “natural” vision. That vision may be clear or blurry and therefore need glasses or a change in glasses. It is not unusual for a 10 year old who wears glasses to need changes during these growing years, and this has nothing to do with diabetes. If her blood sugar is controlled, you can rest assured that this change in her vision is a “natural” change and not related to her diabetes. Although people needing a change in glasses may see more blurry without their glasses, they are not losing their eyesight if they can see 20/20 with their new glasses.
It is most unlikely that, after seven years with diabetes, your daughter would have actual damage to the eye resulting in a loss of best “correctable” vision with glasses. The standard of care is an annual dilated exam to rule this out.
One test in assessing eye health is the patients best “correctable” vision not their unaided vision. Correctable is an old term. A more appropriate term would be “best compensated vision”. Glasses do not “correct”; they compensate.
CAG