Take care of your peepers with these foods.

Diabetes is a condition that prevents your body from producing or responding to the insulin it needs to bring sugar from the blood stream to cells, where it’s burned for energy. Over time, too much sugar—or glucose—in the blood can lead to heart problems, kidney problems and nerve problems, especially in the hands and feet. Diabetes can also damage the blood vessels in the eyes, leading to vision troubles and, potentially, blindness.

Diabetic retinopathy is the leading cause of blindness for everyone from college students to retirees. “I see quite a few people with diabetes who have complications in their eyes,” says Lauren Zimski, MD, an ophthalmologist with Presbyterian/St. Luke’s Medical Center in Denver, Colorado. “As diabetes damages blood vessels, it affects blood flow to the retina, leading to loss of vision.”

Eye anatomy
Think of your eye as a camera. Light enters through the lens, where it imprints on a piece of film or a processor. In this analogy, the retina is the film. The retina “translates” the light it receives from outside the eye and sends the signals through the optical nerve and into the brain.

The retina is fed by blood vessels that branch off from the carotid artery. With diabetes, sometimes these retinal blood vessels swell and leak fluid, and abnormal vessels can grow on the surface of the retina. Both of these changes can result in loss of vision or even blindness.

Where to start
If you have diabetes, are you doomed to go blind? No, says Dr. Zimski, but it’s important to be aware of potential eye problems. “When you’re newly diagnosed, you’re usually sent in for an eye exam,” she says. “It’s unusual to see any eye changes initially, but the longer someone has diabetes and the more poorly it’s controlled, the more likely it is to develop retinopathy.”

Zimski says people with diabetes need to see an ophthalmologist, not an optometrist. An ophthalmologist will do a comprehensive dilated eye exam, which causes the pupil to expand, allowing her to see the back of the eye and check for leaky or abnormal blood vessels on the retina. An optometrist might not do this test, Zimski says.

It’s all about management
Controlled diabetes makes diabetic retinopathy less likely, according to Zimski. “The biggest thing is just having low hemoglobin A1C,” she says, referring to the test that measures the average blood glucose level over the past three months. The same diet you would eat to lower blood sugar—one with little sugar but plenty of fruits, veggies and fiber—make it less likely for diabetic retinopathy to progress if you can keep your A1C tightly controlled.

That’s good news for people with diabetes because it means that the way you should be eating to control your diabetes is the same way to eat to protect your eyes. Here are some foods to keep your eyes nourished and your blood sugar down.

Red meat—Red meat contains alpha-lipoic acid, an antioxidant that may help manage diabetic retinopathy. Go with cuts that are trimmed of fat, two to five ounces at a time.

Tuna—Fatty fish like tuna and salmon are good sources of vitamin D. A 2015 study found that people with diabetic retinopathy were more likely to have a vitamin D deficiency, and the farther along their diabetic retinopathy was, the more likely they were to be deficient. The best natural source of vitamin D is sunlight.

Aside from getting enough alpha-lipoic acid and vitamin D, the best way to control your diabetic retinopathy is to control your diabetes, says Zimski. However, you might want to try the Mediterranean Diet. A 2016 study of nearly 300 people with diabetes, half of whom also had diabetic retinopathy, suggests it can help with certain quality of life aspects. People in the study on the Mediterranean Diet had more self-confidence and felt they were free to eat and drink what they liked.

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