Local eye care specialists answer top 6 questions about diabetic eye disease

November 6, 2015
diabetic-retinopathy--normal vision--birthday

Diabetes can cause abnormal retinal blood vessel growth, leakage and bleeding that leads to blurring, dark spots, and loss of vision.

By Cheryl L. Dejewski

With diabetes at epidemic levels, you probably know (or are) one of the 29+ million Americans with the disease. Whether or not the cause is due to lifestyle (poor diet, lack of exercise), genetics or both, be aware: Diabetes does more than affect blood sugar levels. Without proper precautions, it can rob a person of their sight. And, if you are black, you have up to a three times greater risk of losing vision to diabetes than a white person.

“We would like to give all members of the black community a chance to protect their vision by educating them about the importance of early detection and treatment,” says Mark Freedman, MD, senior partner at Eye Care Specialists, a leading ophthalmology practice that has served the vision care needs of more than 130,000 Wisconsinites since 1985. To help achieve this goal, their team answers the following questions.

1. How does diabetes affect the eyes?

“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 leads to leakage and bleeding that can blur vision and permanently impair sight,” reports Brett Rhode, MD, Head of Ophthalmology at Aurora Sinai Medical Center and a partner at Eye Care Specialists, an ophthalmology practice that specializes in the care of diabetic patients. “For some people, when a routine vision check-up uncovers signs of retinopathy (damage to the retina), it is their first clue that they even have diabetes.”

2. What are the symptoms of diabetic eye disease?

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. 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 it detected?

“Diabetes-related changes in vision can sometimes temporarily affect vision or occur so gradually that people don’t notice or take action. But, even if a person’s vision appears to be good, serious significant damage may be present and progressing. That’s why diabetic eye disease can only be diagnosed through a comprehensive eye examination that includes pupil dilation (enlargement with drops) to best see inside to check the back of the eye for early signs of retinopathy,” explains Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins. David Scheidt, OD, an optometrist and 20-year member of the Wisconsin Diabetes Advisory Group, adds, “Diabetes-related sight loss is often preventable with blood sugar control, 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.”

4. Am I at risk?

“Diabetic eye disease can appear as early as a year after the onset of diabetes, and up to 45 percent of people with diabetes have some degree of retinopathy (damage to the retina),” says Daniel Ferguson, MD, a partner at Eye Care Specialists, where tens of thousands of diabetic patients receive comprehensive care. “All diabetics—Type 1, Type 2, insulin-dependent or not—are at risk, which increases with the number of years you have diabetes. And, because blacks have up to triple the risk of developing diabetes than whites, the threat of vision loss is correspondingly higher. That’s why we can’t stress enough the sight-saving benefits of annual eye exams.”

5. How is diabetic retinopathy treated?

“When treatment is necessary, we have been very pleased with the success of medications (such as Avastin, Eylea and Lucentis) that can be painlessly injected into the eye to decrease blood vessel leakage and inhibit abnormal new growth—thus staving off progression of diabetic eye disease. We evaluate each patient’s response individually to determine if and when (about every 4-12 weeks) they should receive injections. As a result, we have seen amazing results, including not only stabilization of vision, but in some cases, improvement in sight,” reports ophthalmologist Michael Raciti, MD, a local leader in the fight against diabetic eye disease.

6. Should I be screened for diabetic eye disease?

Do you have diabetes? Was your last eye exam more than a year ago? If you can answer “Yes” to those two questions, then it’s time to have your vision checked. Keep in mind that appointments are often covered by insurance, Medicare or Medicaid. If these options are not applicable, arrangements can usually be made to accept cash, check, credit card or financing plan payment. “Don’t hesitate. It’s an opportunity to ensure that you see life to the fullest—now and in the future. And, remember, EVERYONE should have their eyes checked every two years after age 40 for other conditions, like glaucoma, that may be causing permanent vision loss without you even noticing it,” advises Freedman.