Diabetes is one of the leading causes of blindness in the United States, but it is preventable!! And it is not that difficult to take the necessary steps! This article is inspired by an office visit today, where a young diabetic patient showed up after a 3 year hiatus....with eye disease. During the examination, as the bright lights illuminated his retinas, he said "Eh...who needs retinas anyways!". He was less than happy to hear that he is now at risk for severe damage to his eyes, because he did not come in for his routine examinations.
Diabetes: General info
Most of us know a few basic facts about Diabetes. After all, it is a very common disease! Most of us know a friend or relative who is trying to lose weight, watching their diet, or using medications to control blood sugar levels. Some are using pills, others a combination of pills, and many are using injected medications such as Insulin for blood sugar control. And it is pretty common knowledge that the goal is to keep the blood sugar on the lower side to prevent all sorts of problems, including kidney disease, heart disease and stroke. But fewer people understand that blood sugar control is essential in preserving good vision as well. In fact, a study completed in 2001 showed conclusively that tighter blood sugar control results in better preservation of good vision.
Diabetes and Eye Disease
So what happens in the eye when patients begin to see the effects of Diabetes on their vision. There are 3 common ways that vision decreases with Diabetes:
Cataracts: Diabetic patients are much more likely to develop cataracts. Fortunately, this is a reversible cause of vision decrease. Cataract surgery is one of the most common and most successful surgeries performed today.
Macular Edema: Diabetic patients can develop swelling in the macula, which is the area in the center of the retina. It is the most sensitive area for vision. Caught early, and treated with laser, this problem can be controlled. But once the damage is done, it is VERY difficult to reverse the effects of macular edema.
Proliferative Retinopathy: In this situation, Diabetic patients begin to experience growth of abnormal blood vessels from the normal veins of the retina in the back of the eye. These fronds of new growth are fragile, and the bleed and scar. This can lead to tear, scarring and detachment of the retina.
Treatment of Diabetic Eye Disease
Diabetic eye disease is treatable, but if damage due to the last 2 problems is active, it may not be reversible. In the case of cataracts, the technique for surgery is no different than in a patient who does not have diabetes. Laser therapy can halt the progression of diabetic eye disease in both Macular Edema, and Proliferative Retinopathy, but usually cannot reverse damage that has already been done. So...the sooner the diagnosis is made and treatment initiated, the better the prognosis.
The Bottom Line
If you know a diabetic patient, encourage them to get their blood sugar under control. Insist that they follow the protocols, and see a qualified eye doctor every year. Prevention is the key!!
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