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Refractive changes from high levels of blood sugar normally take days to weeks to develop. If you are having symptoms related to eating "something sweet," it would be good to see a medical doctor who could help you get a blood glucose monitor and do an A1C test to see if diabetes or hypoglycemia is involved.

The best way to determine if changes in your prescription are due to diabetes would be to have an A1C test done. If your A1C varies by more than 1% or so, we would expect some possible refractive shift. If your "pre-diabetes" has not yet elevated your A1C levels, it is an unlikely cause, and may be related to other factors that can cause prescription changes, such as incipient cataracts. The best way to find out is to see an eye doctor who will spend some time understanding your history of prescription changes and communicate with your general physician about your A1C levels. At that visit, you can also bring up the chronic irritation to your eyes. I recommend finding a qualified private-practice eye doctor near you on VSP Vision Care's Web site, vsp.com.

Histoplasmosis is a fungal infection more common in the Ohio-Mississippi River Valley. As you noted, there is usually no treatment. However, at your regular dilated eye exam, your eye doctor should evaluate any retinal lesions from the histoplasmosis for recent change. If an area of the affected retina does show any fresh swelling, there are some new treatments, such as intraocular anti-VEGF injections as well as laser, that retinal specialists could try to prevent further loss to your vision. Although you may have missing areas in a peripheral vision test from the histoplasmosis, the concern would be if they are getting larger.

It would be unusual to have any loss of peripheral vision just from being diabetic unless diabetic retinopathy was seen. Changes in your vision that are cleared up with glasses are common around age 36, but it would be good to know what your A1C is to make sure your diabetes is in good control. Any change in your dosage of medication for diabetes should be made in consultation with your physician with your A1C as a guide.

Although nerve damage to the eye could possibly occur due to physical injury during a difficult birth process of a large baby, it is not “commonly” associated with just gestational diabetes. There can always be special circumstances. Please see Gestational Diabetes for more information.

Changing vision is always a concern, but it does not necessarily lead to a true loss of vision. Needing stronger glasses or bifocals for reading is fairly common, and although a person may become dependent on wearing a visual correction, they can still retain great 20/20 vision.

Floaters, flashes, and increased sensitivity to light are also a concern and need to be evaluated through a dilated eye exam. In most cases, although the floaters can be a nuisance, they do not lead to any vision loss. However, in some cases, the retina can be torn or detached, which is sight-threatening and needs immediate treatment.

From your question, it appears that you did see the eye doctor with these symptoms, so if no treatment was recommended, it seems as though you did not have any sight-threatening eye conditions at that time. However, if your vision has continued to change since your last exam, you should get another one, even as a second opinion. Also, you do not mention that you have diabetes, but, if you do, I would have a higher level of concern that you have another dilated exam.

The appropriate laser treatment for significant diabetic macular edema (a swelling of the central part of your visual system) has been shown in well-controlled studies to reduce the risk of more visual loss, but not in all cases. Repeated laser treatment is also indicated depending on your circumstances. If you have had several treatments, and you are continuing to lose vision, I would recommend a second opinion from another retinal specialist to confirm that nothing more can be done.

Intraocular injections are definitely indicated and do help with wet age-related macular degeneration, and some retinal specialists are trying this with some forms of diabetic retinopathy, but this is still not a standard treatment and would be best discussed with your retinal specialist.

Your retinal specialist would be the best person to discuss any change to your recommended eye treatment secondary to your cardiac bypass surgery, but I do know of many patients where cardiac surgery does not change their recommended eye treatment.

What you are describing is an unusual situation as most eye turns that need surgeries only leave one eye with possible amblyopia, the other with normal vision (although glasses may be needed). The number of needed surgeries is commonly about three, although some newer techniques, such as the adjustable-suture, have shown promise. With the thyroiditis, which tends to thicken the eyes muscles, your daughter certainly has some challenges.  In my area (California), I usually refer these complex cases to the Wright Foundation (a 501c3 foundation). Their Web site has a lot of information you may find useful.

If your daughter’s pre-diabetic condition does turn to diabetes, which can make many other conditions more difficult to handle, our major concern of diabetic retinopathy is more related to chronic hyperglycemia, for which we have a lot more tools to control now than we did even 10 years ago.