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Diabetic Eye Problems

One of my goals in updating this blog was to create some informational posts to help patients understand common medical problems. When the National Eye Institute e-mailed me about posting an article on diabetic eye disease, I thought it was a good opportunity to do another such post.

Diabetic retinopathy is the most common cause of diabetic eye problems and is a leading cause of blindness in adults. Diabetic retinopathy affects a significant proportion of patients with diabetes: 38% of diabetic patients in this study, 26-36% of diabetic patients in this study, 27-36% of diabetic patients in this study, and 28% of patients over age 40 with diabetes (about 7 million people) according to NEI estimates.

If you think of the eye as a movie projector, the outside world is the movie being projected (the large red arrow in the first picture below), the lens is the camera lens (yellow in the picture), and the back or the eye (the retina) is the movie screen (grey area to which the three red arrows are pointing). Diabetic retinopathy is caused by damage to the blood vessels in the retina throughout the back of the eye – which damages the “screen” upon which our brains view the world around us. The resulting image to our brains (as shown in the second picture from the National Institute of Health) is blurry with multiple blind spots – as if someone had burned holes in the “movie screen.”
Treatment of diabetic retinopathy involves first controlling one’s glucose levels. If good blood sugar control isn’t sufficient, doctors can use a laser to coagulate some of the damaged blood vessels in the back of the eye. After laser surgery, the back of the eye has many small laser burns (see the white spots on the third picture) which limits the overgrowth of blood vessels.

This is a simplistic explanation of a complex problem and an eye doctor can explain it in more depth. The bottom line, and the point that the National Eye Institute wanted to make, was that regular eye exams in diabetic patients can help find and treat any diabetic vision problems at an early stage when the prognosis is better.

The message from the National Eye Institute is below.

Eye Cross SectionDiabetic retinopathy pictureDiabetic retinopathy laser surgery

Set Your Sight on Healthy Vision if You Have Diabetes

If you have diabetes, your doctors most likely have told you to keep your blood sugar under control through diet, exercise, and proper medication. But did you know that you also need a dilated eye exam at least once a year? A dilated eye exam is when an eye care professional dilates, or widens, the pupil to check the retina in the back of the eye for signs of damage. All people with diabetes, type 1 and 2, are at risk for vision loss, but certain groups are at higher risk: African Americans, American Indians/Alaska Natives, and Hispanics/Latinos.

The longer a person has diabetes, the greater the risk of diabetic eye disease, which includes the following:
•       Cataract (Clouding of the lens of the eye)
•       Diabetic Retinopathy (Damage to the retina)
•       Glaucoma (Damage to the optic nerve)

In November, when National Diabetes Month is observed in the United States, the National Eye Health Education Program (NEHEP) of the National Eye Institute (NEI) recommends that all people who have diabetes reduce the risk of vision loss from the disease by having a comprehensive dilated eye exam at least once a year.

“Half of all people with diabetes don’t get annual dilated eye exams. People need to know that about 95 percent of severe vision loss from diabetic retinopathy can be prevented through early detection, timely treatment, and appropriate follow-up,” said Dr. Suber Huang, chair of the Diabetic Eye Disease Subcommittee for NEHEP.

“Diabetic eye disease often has no early warning signs but can be detected early and treated before vision loss occurs,” said Paul A. Sieving, M.D., Ph.D., director of NEI. “Don’t wait until you notice an eye problem to have a dilated eye exam, because vision that is lost often cannot be restored.” In fact, diabetic retinopathy, the most common form of diabetic eye disease, is the leading cause of blindness in American adults ages 20–74. According to NEI, 7.7 million people ages 40 and older have diabetic retinopathy, and this number will likely increase to approximately 11 million people by 2030.

If you have diabetes, get a comprehensive dilated eye exam at least once a year. NEHEP also recommends you keep your health on track by—
•       Taking your medications.
•       Reaching and maintaining a healthy weight.
•       Adding physical activity to your day.
•       Controlling your blood sugar, blood pressure, and cholesterol.
•       Kicking the smoking habit.

These steps will help you keep your diabetes under control and help protect against diabetic eye disease.

For more information on diabetic eye disease, financial assistance for eye care, and how you can maintain healthy vision, visit www.nei.nih.gov/diabetes or call NEI at 301–496–5248

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