Diabetes & Hypertension

In the United States, Diabetic eye disease is the number one cause of blindness in patients under the age of 55. However, with annual eye examinations and good diabetic management, vision can be preserved. The following are some of the conditions that may affect the eyes of Diabetics:


Diabetic Retinopathy

Diabetic retinopathy causes damage to the blood vessels in the retina, and can affect people with Type I or Type II diabetes. The disease usually affects both eyes. If left untreated blindness can occur.

Stages of Diabetic Retinopathy include:

  1. Mild Nonproliferative Retinopathy- Microaneurysms (small areas of swelling similar to a balloon) develop in the tiny blood vessels of the retina.
  2. Moderate Nonproliferative Retinopathy- The blood vessels that support the retina are blocked.
  3. Severe Nonproliferative Retinopathy- The retina is not nourished properly due to the increased blockage of blood vessels. The retina sends a chemical signal for the eye to form new blood vessels.
  4. Proliferative Retinopathy- New abnormal and fragile blood vessels develop along the surface of the retina. Since these new vessels have fragile walls, leakage of blood may occur, which could result in severe vision loss and may require complex surgery.

In the retina, the macula is responsible for straight ahead vision, fine detail and reading. If fluid leaks in the center of the macula, swelling and macular edema, may occur, resulting in vision loss. Generally, macular edema can develop during any stage of the disease. However, it is more likely to occur as Diabetic Retinopathy progresses.

Treatment Options

Unless macular edema occurs, during the first three stages of Diabetic Retinopathy, no ocular treatment is usually necessary. However, to prevent the advancement of the disease, diabetic patients should take appropriate measures to keep their blood sugar and pressure under control. Proper diet and exercise are very important. Laser treatment is utilized in the Proliferative stage of Diabetic Retinopathy. The goal is to cause regression of the abnormal blood vessels, which in turn can preserve the remaining vision.

Generally, no symptoms are present during the early stages of Diabetic Eye Disease. However, if macular edema occurs, patients may experience blurred vision. If you notice dark spots “floating” in your vision please contact Dr. Najafi-Tagol as soon as possible for an exam. These floaters may be indicative of Diabetic Retinopathy.


Hypertension (High Blood Pressure)

Changes in the blood vessels in the retina can be seen in patients with hypertension. In undiagnosed or uncontrolled cases of hypertension, these small blood vessels may become narrowed, and on occasion occluded, resulting in loss of vision. Unlike diabetes, this symptom would be more likely to occur in one eye. Laser or other medical treatment of the affected eye may be employed depending on the location of the occlusion. The best defense against Hypertensive Eye Disease is close medical control of blood pressure as coordinated by your primary care physician.



A cataract is a clouding of the lens in the eye, causing vision to become blurry. Cataracts develop at an earlier age in people with diabetes, and can occur in one or both eyes. The clouding usually occurs slowly, but can happen quickly, especially after trauma to the eye. While cataracts are not painful, they do cause many symptoms such as blurry vision, decreased details, glare while driving or reading, dull colors, frequent changes in your glasses prescription, and double vision in one eye. If you notice any of the above symptoms, please contact our office immediately.



Glaucoma begins when pressure builds up in the eye, causing damage to the optic nerve, which will ultimately lead to loss of vision. People with diabetes or heart disease are more likely to develop glaucoma than other adults. Early diagnosis of Glaucoma can prevent the potential blindness it can cause if left untreated. In the early stages, glaucoma is a symptomless disease, which accentuates the importance of periodic eye examinations that include a glaucoma screening, particularly after the age of 40. Please contact our office today to schedule your annual eye exam.


Dr. Najafi-Tagol recommends the following methods to prevent eye problems:

  1. For Diabetics, Keep your blood sugar (glucose) level in check. Paying close attention to your diet, exercise, and measuring your levels daily will help. It is recommended by the American Diabetes Association that all Diabetics have an annual eye examination.
  2. Keep your blood pressure under control. Elevated blood pressure can lead to eye problems. Among other things, checking your blood pressure regularly, exercise and avoiding salty foods can help keep your blood pressure in check.
  3. Stop Smoking. Among other harmful side-effects, the risk of developing eye diseases, such as Macular Degeneration, is increased by smoking.
  4. Schedule an annual eye exam. Many serious eye conditions may go unnoticed for years unless detected through a comprehensive eye examination.
  5. Contact Dr. Najafi-Tagol if you experience the following conditions:
    • blurry or double vision
    • headache
    • change in peripheral (side) vision
    • trouble reading or driving at night or daytime
    • pain in one or both eyes
    • eye pressure
    • seeing floaters or spots in your vision
    • redness in eyes

Eye Institute of Marin emphasizes the use of state-of-the-art technology to provide the most accurate and complete findings for early diagnosis and treatment of these and other eye conditions with the goal of preventing vision loss and blindness.