by Adie
QUESTION:
By Adie
My father has had type 2 diabetes for 15 years. Recently he has had eye pain, intermittent blurred vision and eyes that sometimes become very red. His diabetes was controlled, but he is now having unexplained blood sugar spikes. Are these symptoms diabetic eye complications, and how can I help him?
Quick Answer
Diabetes can cause retinopathy, macular edema, cataracts and glaucoma, but a red, painful eye with reduced vision is not typical uncomplicated diabetic retinopathy. He needs an urgent eye examination—preferably the same day. Sudden severe pain, sudden vision loss, halos around lights, headache, nausea or vomiting can signal acute angle-closure glaucoma or another sight-threatening emergency. Blood sugar spikes may temporarily blur vision, but they do not safely explain persistent eye pain or marked redness.
Answer by Dr. Albana Greca, MD, MMedSc
Hello Adie,
Arrange urgent ophthalmology assessment rather than waiting for glucose to improve. Pain, redness and reduced vision can signal a sight-threatening condition.
Diabetic eye disease includes:
Retinopathy is not “clotting of the arteries.” High glucose damages retinal capillaries, which may leak, close or produce fragile new vessels.
Read our diabetic eye problems guide.
Usually not. Retinopathy often has no early symptoms. Later it may cause blur, floaters, dark areas or vision loss, but it is commonly painless.
A red, painful eye suggests another condition, including:
Go to emergency eye care now for sudden vision loss, severe eye pain, a very red eye with blurred vision, halos around lights, severe headache, nausea or vomiting, a new curtain or shadow, flashes with many new floaters, eye injury, a fixed or unusually shaped pupil, or weakness or speech difficulty.
He should not drive with impaired vision. Do not patch or press on the eye or wait for a routine appointment.
Yes. Rapid glucose changes alter lens fluid balance and may temporarily blur vision until glucose stabilizes.
They do not usually cause a markedly red, painful eye, so do not assume every change will resolve with glucose.
Record glucose, timing and symptoms. See our time-of-day guide.
Review HbA1c, glucose patterns, medicines, kidney function and infection. Do not change medicine for one reading.
Treatment depends on the diagnosis. Retinopathy, glaucoma, uveitis and infection need different care. See our treatment guide.
Steroid drops can worsen infection and raise eye pressure; use them only under specialist supervision.
Type 2 diabetes requires a dilated exam from diagnosis. Normal findings may allow one-to-two-year intervals; retinopathy needs at least annual review.
Manage glucose, blood pressure and cholesterol and attend eye exams. Read our complications guide and cataract guide.
This answer does not replace urgent examination of a red, painful eye.
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