Will diabetic eye disease affect someone you know?
November is Diabetes Awareness Month
Diabetes is being diagnosed in epidemic numbers across all ages and races. This increase means a corresponding surge in complications related to the disease, including sight-robbing “diabetic retinopathy”—now the leading cause of blindness in the U.S. If you are black, you have a three times greater risk of losing vision to diabetes than a white person. And, Latinos in every subgroup (Mexican, Cuban, Puerto Rican, etc.) are not only at higher risk of developing diabetes, but are also twice as likely to suffer from more severe diabetic complications.
"Of the nearly 26 million Americans diagnosed with diabetes, up to 45 perecent have some degree of diabetic retinopathy (damage to the sensitive retina in the back of the eye), which can lead to vision loss and blindness,” reports Dr. Norman Cohen, an eye surgeon who has treated thousands of diabetic patients since 1975. “For some people, when a routine vision check-up uncovers signs of retinopathy, it is their first clue that they even have diabetes.”
How diabetes affects vision
With diabetes, high blood sugar levels can weaken blood vessels in the eye, causing them to leak. This causes the retina to swell and form deposits that can lead to vision loss. Blood sugar fluctuations can also promote the growth of new, fragile blood vessels on the retina, which can sometimes leak blood into the vitreous (the clear, jelly-like substance that fills the eyeball). This retinal blood vessel damage, or retinopathy, can blur vision and lead to permanent sight impairment.
Who is most at risk?
"Diabetic eye disease can appear as early as a year after the onset of diabetes. All diabetics—type 1 or 2, insulin-dependent or not—are at risk. And that risk increases with the number of years you are diabetic. For example, patients with diabetes for less than five years have about a 15 percent incidence of retinopathy. This skyrockets, however, to 80 percent in people with diabetes for 15+ years,” says Dr. Robert Sucher, co-founder of Eye Care Specialists. He adds, “Because African-Americans have a higher incidence of diabetes, they are also at higher risk of blindness from diabetic eye disease.”
What are the symptoms?
Usually, none. Most people don't notice a problem until retinopathy is so far advanced that lost vision can't be restored. That’s why annual dilated eye exams are crucial. You should also call your doctor immediately if you notice vision changes in one or both eyes (not associated with fluctuations in blood sugar), numerous floating spots (like spider webs), or a veil over your vision.
How is retinopathy detected?
Eye care specialist Dr. Daniel Ferguson notes, "It is vital for people with diabetes to understand that significant retinopathy may be present and progressing even if their vision appears to be good. And, because fluctuations in blood sugar levels can temporarily affect vision, it's sometimes hard to know if a serious eye problem is developing.” Diabetes-related eye damage can only be diagnosed through a comprehensive eye examination. Pupil dilation (enlargement with drops) is necessary to best check the back of the eye for early signs of retinopathy, such as microaneurysms (tiny blister-like outcroppings on retinal blood vessels that can bulge and leak), before noticeable vision loss occurs.
Prevention and Treatment
“Diabetes-related sight loss is often preventable with yearly exams and early intervention. But all of our expertise, lasers and treatments are of no use if patients don’t come in for regular eye check-ups,” comments Dr. David Scheidt, optometrist and 17-year member of the Wisconsin Diabetes Advisory Group.
“We have been very pleased with the success of medications that can be painlessly injected directly into the eye to stave off progression of the disease. We typically use Avastin because it is both cost-effective and works to inhibit the growth of the abnormal blood vessels related to diabetic retinopathy,” says Dr. Brett Rhode, an ophthalmologist who has conducted continuing education programs for area diabetes coordinators. An ophthalmologist who sees patients at all three Eye Care Specialists’ locations, Daniel Paskowitz, MD, PhD, adds, “We have seen some amazing results with Avastin, including not only stabilization of vision, but in some cases, improvement in sight. However, we must evaluate each patient’s response individually to determine if and when (often every 6-12 weeks) they should receive injections.”
Although not all diabetics can have or need it, laser treatment can also be effective in reducing the incidence of severe vision loss, especially if started early enough,” notes Daniel Ferguson, MD, who treats thousands of patients each year with diabetes, cataracts, glaucoma, macular degeneration, and other concerns.
FREE Booklets & Information
Eye Care Specialists’ doctors are dedicated to providing the highest quality cataract, glaucoma, diabetic eye disease, macular degeneration, dry eye, and laser vision correction care. They frequently lecture to the public and fellow physicians and have written their own series of booklets on these conditions. Call 414-321-7035 for FREE copies or to schedule an appointment for a thorough examination at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National. They also offer information at www.eyecarespecialists.net.
Tips for Protecting Against Diabetes-Related Vision Loss
• Have a blood sugar test every three years after age 45 to screen for diabetes
• Keep blood glucose levels close to normal through diet, medication and exercise
• Keep blood pressure under control
• Don’t smoke
• Keep cholesterol levels low
• Check hemoglobin A1c levels at least every four months and aim for less than 7.0
• Schedule dilated eye exams once a year, or as often as your Eye M.D. suggests