Doctors caution about diabetic vision loss

Staff Reports • Updated Nov 4, 2013 at 3:24 PM

In observance of American Diabetes Month this November, ophthalmologists across Tennessee are reminding the 530,000 Tennesseans living with diabetes – the leading cause of new cases of blindness among adults age 20 to 74 years – of the key steps they should take to prevent vision loss.

Diabetes is a major risk factor for cataract, glaucoma and diabetic retinopathy, the most severe of the three eye diseases, which affects approximately 7.7 million Americans. Diabetic retinopathy is more than twice as common in Mexican Americans and nearly three times as common in African-Americans as in non-Hispanic whites.

The Tennessee Academy of Ophthalmology and the American Academy of Ophthalmology advise that diabetic eye diseases can be prevented and their progression can be slowed through early detection and diligent diabetes care. Yet, only 10 percent of people with diabetes in medically underserved communities get screened yearly for diabetic retinopathy.

In diabetic retinopathy, the small blood vessels inside the retina at the back of the eye are damaged, causing them to leak fluid into the retina, which is the light-sensitive tissue in the back of the eye. This is known as macular edema and is the leading cause of moderate vision loss in people with diabetes. As the disease progresses, abnormal blood vessels can grow on the surface of the retina, a process called proliferative retinopathy. These vessels can bleed and form scar tissue, which can ultimately cause blindness.

To help prevent these complications, the Tennessee Academy of Ophthalmology and the American Academy of Ophthalmology recommend that people with diabetes take the following steps:

• Get a comprehensive dilated eye examination from your ophthalmologist once a year, regardless of your age.

In its early stages, diabetic retinopathy often has no symptoms. A dilated eye exam allows ophthalmologists – medical doctors who specialize in the diagnosis and medical and surgical treatment of eye diseases – to examine the retina and optic nerve more thoroughly for signs of damage before changes in vision occur. Regular monitoring of eye health allows ophthalmologists to begin treatment as soon as possible if signs of disease do appear. Women with diabetes who become pregnant may need additional eye exams throughout their pregnancy, as pregnancy can sometimes worsen diabetic retinopathy. People ages 65 years and older without regular access to eye care or for whom cost is a concern may qualify for EyeCare America, a public service program of the Foundation of the Academy, which partners with the Knights Templar Eye Foundation to offer eye exams and care at no out-of-pocket cost for eligible seniors.

• Maintain close-to-normal blood glucose (sugar) levels.

High blood glucose damages the blood vessels in the eyes. This damage can result in swelling in the retina and the development of abnormal blood vessels that can bleed and form scar tissue. Additionally, when blood glucose levels are too high, the shape of the eye’s lens can be affected, causing blurry vision that goes back to normal after the blood glucose levels are stabilized.

• Maintain healthy blood pressure and cholesterol levels.

High blood pressure and high cholesterol can increase the risk of eye disease and vision loss. Keeping both under control will help the eyes as well as overall health.

• Quit smoking.

Smokers are at an increased risk for diabetic retinopathy and other diabetes-related eye diseases.

• Exercise regularly.

Regular exercise can help the eyes stay as healthy as possible while helping to control blood glucose levels.

Careful diabetes management is the best way to prevent vision loss. Although treatments are not usually curative, they can reduce the risk for vision loss and include injectable medications, laser surgery and vitrectomy surgery, during which blood and scar tissue from abnormal vessels are removed.

“The Tennessee Academy of Ophthalmology urges Tennesseans with diabetes to visit their ophthalmologist on an annual basis,” said Dr. Ben Mahan, TNAO president. “Only ophthalmologists are medically trained to treat complicated eye diseases such as diabetic retinopathy. Consistent eye care by an ophthalmologist will allow diabetes patients to maintain optimum eye health for as long as possible, and will also provide an opportunity for eye disease to be caught and treated early.”

The Academy offers a free educational DVD – which can be ordered through its public education website, geteyesmart.org – about preventing and treating diabetic eye diseases. The video features Chicago Bears center Roberto Garza, whose grandfather lost his sight due to diabetes.

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