November is Diabetes Awareness Month, making it a good time to think about how diabetes can affect your eyes. Many people with diabetes focus on blood sugar, diet and medications, but eye health is easy to overlook, especially when your vision seems fine.

That is part of what makes diabetic eye disease so concerning. The most common form, diabetic retinopathy, often causes no symptoms in its early stages, and by the time vision changes become noticeable, damage to the retina may already be significant.

Diabetic retinopathy develops when high blood sugar damages the small blood vessels that supply the retina, the light-sensitive tissue at the back of the eye. These vessels can leak, swell, or become blocked, and in advanced stages fragile new vessels can grow and bleed. Swelling in the center of the retina can also blur sharp, central vision.

Early on, you may not notice anything at all. As the condition progresses, symptoms can include blurry or fluctuating vision, new floaters or dark spots, areas of missing vision, or faded colors. Because these changes often develop gradually, they are easy to dismiss as tired eyes or a change in your prescription. Sudden vision loss, a shower of new floaters, flashes of light or a shadow across your vision should be evaluated right away.

Diabetes can affect other parts of the eye as well. People with diabetes tend to develop cataracts earlier and have a higher risk of glaucoma. Changes in blood sugar can also cause temporary blurry vision and shifts in your prescription, which is another reason to tell your eye doctor if your vision seems to come and go.

This is why an annual dilated eye exam is so important. Drops are used to widen the pupils so your doctor can closely examine the retina and optic nerve, and imaging tests can reveal swelling or other changes that may not be visible otherwise. The goal is to find problems early, when treatment is most effective.

Timing matters, too. Adults with type 2 diabetes should have a dilated eye exam soon after diagnosis, since the condition may have been present for years before it was found. Those with type 1 diabetes should generally have a first exam within five years of diagnosis. After that, yearly exams are recommended.

The good news is that diabetic retinopathy can be treated, and early care makes a real difference. Depending on the stage, options may include laser treatment, injections to reduce swelling and abnormal blood vessel growth, or surgery for more advanced cases.

There are also steps you can take at home. Keeping blood sugar, blood pressure and cholesterol within the targets set by your primary care doctor or endocrinologist is one of the most effective ways to protect your eyes. Take medications as prescribed, stay active, eat a balanced diet and avoid smoking.

If you have diabetes and haven’t had a dilated eye exam in the past year, don’t wait for symptoms to prompt a visit. Bring a list of your medications and your most recent A1C results so your eye doctor has the full picture.

Living well with diabetes means caring for your whole body, and your eyes are an important part of that picture. Keeping your appointments and addressing changes early can help you protect your sight for years to come.

Omar Gayasaddin, D.O., is a board-certified, fellowship-trained ophthalmologist with Florida Eye Specialists, specializing in laser cataract and glaucoma surgery as well as comprehensive eye care. For more information, visit FloridaEyeSpecialists.com or call (904) 564-2020.