Eye Care & Diabetes
By Martin N. Novey, O.D., Katzen Eye Group
The Numbers
The American Diabetes Association estimates that there are approximately 18,200,000 Americans with diabetes and over 25% of these individuals are unaware they have the disease.
Diabetes very often affects the eyes and is the leading cause of blindness among adults 20-74 years old. An estimated 40.3% of those with diabetes show some degree of diabetic eye disease, called diabetic retinopathy. Diabetic retinopathy occurs when the blood vessels in the back of the eye become weakened and damaged. This can cause swelling or leakage of blood in the eye, which can severely affect your vision.
Unfortunately, diabetic retinopathy can develop even with those who do an excellent job of controlling their blood sugar.
The National Eye Institute’s recently published “Vision Problems in the USA” reveals that there are well over 100,000 individuals in Maryland with diabetic retinopathy. Diabetic patients are also found to have a higher incidence of cataract and glaucoma than the general population.
For all these reasons, it is critically important that anyone with diabetes receives timely regular eye examinations
Signs & Symptoms of Diabetes
Regardless of any symptoms, ALL diabetic patients should have, at a minimal, annual exams that include using the eye drops that dilate your pupils. Some of the symptoms that would require an immediate visit to the eye doctor include recent onset of blurred vision (frequently one of the first signs of diabetes is a fluctuation in vision, even from day to day), a change in your central vision that makes things appear distorted or twisted, new floaters, flashes of light & floaters or a curtain over one’s vision.
The standard dilated eye exam will reveal focusing problems that might indicate an increase in blood sugar levels. Many new advanced techniques utilizing the latest technology can help evaluate the blood vessels in the back of the eye. One of the most important points to remember is that if your eye doctor catches the effects of diabetes in the eye early enough, there are many things that can be done to help prevent any loss of vision.
Disease Progression
Individuals with mild to moderate diabetic retinopathy will need to be followed every 6-12 months and sometimes more frequently depending on the level of swelling or leakage of blood in the back of the eye.
With advanced diabetic retinopathy new blood vessels are growing in the back of the eye and can cause severe damage and loss of vision.
Initial treatment is usually with a laser though more severe cases may require surgery, which is now actually an out-patient procedure.
Primary Care Management
Control of your blood sugar is critical to minimizing the risk of diabetic retinopathy. Properly controlled blood sugar can reduce the development of diabetic retinopathy by 75% and will slow the progression of existing diabetic retinopathy by 54%. Other factors that reduce the incidence or progression of the retinopathy include control of blood pressure and cholesterol levels.
Of paramount importance is to be certain that each and every individual with a diagnosis of diabetes schedules an initial eye examination and annual exams thereafter.