You may not usually think about the effect of kidney disease on your eyes, but eye symptoms are common for people with chronic kidney disease (CKD), including those with complement 3 glomerulopathy (C3G). Eye problems can occur as a direct result of poor kidney function and associated conditions, like diabetes and CKD treatments.

In this article, we’ll review common eye problems in kidney disease, the symptoms they can cause, and ways to manage them.

What’s the Connection Between Kidney Disease and Eye Problems?

There are many ways that kidney disease can harm the eyes, including through:

• Shared damage to small blood vessels in both organs
• Conditions like diabetes and hypertension (high blood pressure)
• Oxidative stress (imbalance between harmful molecules and the body’s defenses)
• Inflammation, which can damage blood vessels
• Uremia (high levels of waste products in the blood)
• Anemia (low red blood cell counts)
• Vitamin and mineral imbalances

Some treatments for kidney disease can also harm the eyes. Dialysis (treatment to filter waste from the blood) can create fluid shifts and pressure changes, and steroid use can raise the risk of cataracts and glaucoma.

This damage can lead to various eye problems, including:

• Retinopathy — Damage to the retina (the tissue in the back of your eye that senses light)
• Glaucoma — A condition that can cause vision loss from increased pressure in the eyes
• Age-related macular degeneration — Damage to the central part of the retina (called the macula)
• Cataracts — Cloudiness in the eye

Eye problems associated with kidney disease can cause several different symptoms that affect your eyes.

Eye Puffiness

Eye puffiness can be caused by excess fluid in the body building up around your eyes. This can make it look like you have bags under your eyes.

Edema (fluid buildup) due to kidney disease is often associated with swelling in the hands, feet, and lower legs. However, fluid can also collect around your eyes, making them look puffy and swollen.

When your kidneys aren’t working well, they can allow protein to leak out into your urine — a phenomenon known as proteinuria. With lower protein levels in your body, fluid can build up around your eyes. This causes puffy, swollen eyes that don’t go away.

Managing Eye Puffiness

There isn’t a specific treatment for puffy eyes, but a common home remedy is to apply a cool compress around your eyes to temporarily reduce puffiness. You can also minimize other causes of puffy eyes, such as lack of sleep and allergies. Managing kidney disease and proteinuria may also help reduce the look of puffy eyes. Talk to your healthcare team to find out the best treatment options for you and how they may affect your puffy eyes.

Blurred Vision

Blurred vision is when your vision isn’t sharp, so you can’t see objects as clearly as usual. In most cases, blurred vision happens gradually. Several eye problems associated with kidney disease can cause blurred vision, including retinopathy, macular degeneration, glaucoma, and cataracts.

Retinopathy in kidney disease is commonly linked to diabetes, a condition known as diabetic retinopathy. In this form of retinopathy, high blood sugar damages the small blood vessels in the retina. Macular degeneration can also lead to blurry vision. In people with C3G, drusen (deposits under the retina) accumulate beneath the macula, affecting vision. In severe cases, retinopathy can lead to retinal detachment, where the retina separates from the back of the eye. This can result in significant vision loss, often requiring surgery to prevent permanent damage.

In glaucoma, blurry vision is caused by increased pressure on the optic nerve — the nerve that carries information from your eyes to your brain. When cataracts form in the lens, blurry vision can result.

Managing Blurry Vision

Blurry vision may improve by treating the underlying cause.

In people with kidney disease, fluid buildup can result in very high blood pressure that can cause sudden blurry vision.

In addition to the sudden onset of blurry vision, other warning signs of serious eye problems include sudden onset of the following symptoms:

• Floaters (dark shapes or lines in your vision)
• Flashes of light
• Loss of peripheral (side) vision

Dry, Irritated Eyes

If you have dry eyes, your eyes may feel gritty and uncomfortable, and they may look red. People with kidney disease may be more likely to experience dry eyes because of decreased tear production and changes in the makeup of tears.

Additionally, poor kidney function can cause a buildup of calcium and phosphate in your blood. These substances can deposit in your eyes, causing irritation.

Managing Dry Eyes

Lubricating eye drops can help make your eyes feel more comfortable by adding a protective layer of moisture to the surface of your eyes. Managing the levels of calcium and phosphate in your blood may also help prevent irritated eyes.

Changes in Color Vision

Eye problems associated with kidney disease can also change the way you see colors. For some people with eye conditions, like macular degeneration or cataracts, colors may seem dull or faded. Some colors may also look different than you’re used to.

Managing Changes in Color Vision

Some small lifestyle changes may help you manage changes in your color vision. For example, using brighter lights can help you to see colors better. Labeling and organizing can also help you recognize clothes or objects. Managing the underlying cause of color vision loss may also improve your ability to see colors.

Changes in your color vision usually happen gradually and can be difficult to notice. Regular eye exams can help catch problems like these early.

Vision Loss

Vision loss is when your vision becomes worse. Some eye problems associated with kidney disease can also cause permanent blindness (a lack of vision).

Retinopathy and macular degeneration can cause vision loss if the retina becomes permanently damaged. Increased pressure on the optic nerve can lead to vision loss due to glaucoma.

Managing Vision Loss

In most cases, vision loss occurs gradually. Regular follow-up with your healthcare provider can help catch eye problems while still in the early stages when vision loss may be prevented.

If you’re living with low vision or vision loss, using bright lights and magnifying devices may help you read and see better.

Managing Eye Problems With Kidney Disease

If you have chronic kidney disease, it’s important to regularly monitor your vision and eye health to prevent serious problems that can lead to vision loss or blindness. An eye doctor, such as an ophthalmologist, can check for eye diseases that can affect your vision.

Work with your nephrologist (kidney doctor) and other members of your healthcare team to manage health conditions associated with kidney disease, such as high blood pressure and diabetes. Hitting your treatment goals may help protect your vision.

Talk With Others Who Understand

On MyKidneyDiseaseTeam, the site for people with kidney disease and their loved ones, people come together to gain a new understanding of different kidney diseases and share their stories with others who understand life with kidney disease.

Have you had any vision changes associated with kidney disease? Share your experience in the comments below, or start a conversation by posting on your Activities page.