Q: I’ve heard that people with diabetes have a higher risk for eye issues and vision problems. Is this something I need to worry about with my child?

A: The short answer is that yes, eye health is something you should be aware of. But as you’ll see, there’s no need to panic.

The main eye disease that impacts patients with diabetes — both type 1 and type 2 — is diabetic retinopathy. The retina, which is the tissue that lines the back of the eye, has lots of blood vessels in it that can be damaged by high blood sugars. The damage can be mild, moderate, severe, or, in the most extreme case, proliferative. This last stage is when new blood vessels are formed. This might sound like a good thing, but these new blood vessels can break, bleed, and scar, causing vision loss and retina detachment.

There’s one other major eye complication that can happen with diabetes: diabetic macular edema. This is when fluid leaks into the central part of the retina and it swells up like a sponge. Everyone with diabetic macular edema also has some retinopathy, but this could just be a mild form of the disease. The more severe a person’s retinopathy gets, the likelier they are to also have macular edema.

Now, here’s the part where I reassure you not to panic. Comprehensive dilated eye exams can catch eye disease early, before there is any vision loss. Because diabetic retinopathy can progress silently, it’s important to get the back of your child’s eyes checked regularly even if they don’t have any visual symptoms. We recommend your child get their first eye exam within five years after they are diagnosed with diabetes. It’s relatively uncommon for patients with type 1 to develop advanced eye complications within the first five years, so you don’t need to rush to do this sooner. After that, a yearly eye exam is recommended, with more frequent follow-up as needed. It’s also important to realize that managing blood sugar, cholesterol, and blood pressure helps prevent new or worsening diabetic eye disease.

And here’s some other good news: If eye complications do develop, we can use lasers to prevent or reduce new blood vessel growth (remember, that’s the sign of the most extreme form of diabetic retinopathy) and treat diabetic macular edema. In the last decade we’ve also developed a class of medications called anti-VEGF drugs (anti-vascular endothelial growth factor). These are a series of treatments applied to the eye usually once a month. You get lots of numbing drops first, so usually discomfort is minimal or over very quickly. Our treatments are good enough now that as long as your child comes in for routine eye exams and gets treated if needed, the odds of preserving excellent vision are really good.

—Jennifer Sun, M.D., M.P.H., is an associate professor in the department of ophthalmology at Harvard Medical School, chief of the Center of Clinical Eye Research and Trials at Joslin Diabetes Center’s Beetham Eye Institute, and chair of Diabetes Initiatives for the DRCR Retina Network.

Disclaimer: The information in this article is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.