Diabetes is reaching epidemic levels across all ages and races. Chances are you know (or are) one of the 25.8 million Americans with the disease. If so, take note. Diabetes does more than affect blood sugar levels. It is now a leading cause of blindness in the U.S. And, if you are black, you have a three times greater risk of losing vision to diabetes than a white person.
1. How diabetes affects vision
With diabetes, fluctuating and high blood sugar levels can cause the blood vessels that nourish the retina in the back of the eye to become weak or abnormal. This can lead to leakage and bleeding that can blur vision and permanently impair sight. “Of the nearly 26 million Americans diagnosed with diabetes, up to 45 percent have some degree of diabetic retinopathy (damage to the retina), which can lead to vision loss and blindness,” reports Dr. Mark Freedman, a partner at Eye Care Specialists, a local ophthalmology practice that specializes in the care of diabetic patients. “For some people, when a routine vision check-up uncovers signs of retinopathy, it is their first clue that they even have diabetes.”
2. 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.
3. How is retinopathy detected?
“Fluctuations in blood sugar levels can temporarily affect vision, making it difficult to know if a serious eye problem is developing. Significant retinopathy may also be present and progressing even if a person’s vision appears to be good. That’s why 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 before noticeable vision loss occurs,” explains Dr. Brett Rhode, Head of Ophthalmology at Aurora Sinai Medical Center.
4. Prevention and treatment
“Diabetes-related sight loss is often preventable with yearly exams and early intervention. But all of our expertise, equipment and treatments are of no use if patients don’t come in for regular eye check-ups,” comments Dr. David Scheidt, optometrist and 18-year member of the Wisconsin Diabetes Advisory Group.
“When treatment is necessary, 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,” reports Daniel Ferguson, MD, an eye care specialist who treats thousands of patients each year with diabetes, cataracts, glaucoma, macular degeneration, and other concerns. Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins, 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 (about every 4-12 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.
5. 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 the 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. But, the risk rate skyrockets to 80 percent in people who have diabetes for 15 or more years,” says Dr. Michael Raciti, an ophthalmologist at Eye Care Specialists. He adds, “Because African-Americans have a higher incidence of diabetes, they also have a higher risk of going blind from diabetic eye disease. That’s why we can’t stress enough the sight-saving benefits of annual eye exams.”
FREE Booklets and 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 Ave., Mayfair Road across from the mall, or 102nd & National Ave. They also offer information at www.eyecarespecialists.net.