What is causing my visual problems?

Ask our CDE

What is causing my visual problems?

Dear CDE:

After having had (undiagnosed and untreated) Type 2 diabetes for anywhere from 5 to 10 years, for the past three months I have gotten serious about it and have my blood sugar under control. (I am on Actos Plus Met 15/850 - 2x a day) and Glimiperide (2x a day). I'll be 50 in August.

However, I have found that since I have my sugar under control, I am having visual disturbances I have never had. My A1C of 8.9 went to 6.5 in 3 months.

One eye doctor says that the flickering I see in my eyes and the fact that when I look into "light", my vision becomes dark is due to my body re-adjusting to now having low blood sugars, another doctor says this is optic neuropathy, another says it is retinopathy. I am unable to look at the computer for long, nor the tv for long.

What could be going on, based on your experience? Just as importantly to me, WHY NOW, that I am finally taking care of myself is all this vision stuff coming about please? I'm terrified of going blind overnight.

Thanks in advance,


Dear Babs,

I understand your fear of going blind overnight, and WHY NOW, when you are concentrating on helping yourself?!?!? First of all, I recommend you see an ophthalmologist, and have a complete eye exam, including dilation and retinal exam. An ophthalmologist is a physician who specializes in eyes. They differ from an optometrist, who has less expertise in diagnosing eye disease, but who also may be referred to as an “eye doctor”. The ophthalmologist can give you more accurate information on what is happening with your current eye situation.Several things could be happening. When your blood sugar (blood glucose – or bg) is elevated and comes fairly rapidly into a lower range, that causes a fluid shift in your eye. The fluid shift by itself can cause vision disturbances.

After several months of good control your vision may equilibrate on its own. However, sometimes the move from high bg to normal bg is a bit of a shock to the system, and can actually cause bleeding in retinal capillaries…those tiny blood vessels inside your eye. If this is the case, laser therapy can take care of the little “bleeders” fairly easily, but it is important to get treatment early on. Your ophthalmologist may be able to do the laser treatment or s/he can refer you.Finally, it could be something else completely. The bottom line is that you need to have an ophthalmologist who is skilled in looking into, and treating, the eyes of a diabetic person. They can give you the surest advice.A dilated eye exam may sound scary, but usually is not. They put drops in your eyes, and give you a few minutes (usually 10 -15 minutes is long enough) to dilate. You’ll know when your pupil dilates, because your vision gets fuzzy and small print is hard to read. Then the ophthalmologist uses a light to look through your pupil at your retina. The worst part is the bright light in your eyes. The drops wear off in a few minutes to a few hours. Be sure to protect your eyes by wearing sunglasses outside as long as your eyes are dilated.

The American Diabetes Association recommends people with diabetes visit their ophthalmologist yearly for a dilated retinal exam (what I just described). That way any changes can be noticed and treated without the delay that could cause long-term damage to your vision. Keep up the good work with your bg control. An A1c of 6.5% is excellent!!!!! I urge you to see the ophthalmologist as soon as you can. I am familiar with Fear as an unwanted life-partner; he makes a bad companion. The sooner you get help, the sooner you can kick fear out of bed!