Why eye exams are crucial for those who are at high risk, or are already living with diabetes.
November 13, 2009
Diabetes is a serious disease that can bring about complications such as blindness and other vision-related disabilities.
According to Prevent Blindness America, diabetes is the leading cause of new cases of blindness in adults 20-74 years of age. A new study estimates that the number of diabetes patients who have diabetic retinopathy will increase from 5.5 million in 2005 to 16 million by 2050. The "Projection of Diabetic Retinopathy and Other Major Eye Diseases Among People With Diabetes Mellitus" by Jinan B. Saaddine, M.D., M.P.H., et al, also stated that the number of diabetes patients with cataracts will increase to 10 million and the number with glaucoma will increase to 1.4 million.
The study also predicts a dramatic increase in the number of eye disease cases in Hispanic and African American populations. The research estimates that Hispanics with diabetes in all age groups will have substantially large increases in diabetes-related eye disease. African Americans are five times more likely than Caucasians to develop glaucoma. And, rates for African Americans with diabetes with glaucoma are expected to rise the most among those age 50 and older; and the rates of cataracts for those 75 and older is expected to increase more than 600 percent in women and close to 700 percent in men.
If you have diabetes or are at high risk, it is crucial that you see an eye doctor at least once a year. For some, diabetic retinopathy is one of the first signs that they have diabetes, which is why annual eye exams are so important.
Some Quick Facts About Diabetes and Vision Loss
Examining the small blood vessels in the eye (called capillaries) is an important part of a comprehensive eye exam. Since diabetics can have difficulty controlling their blood sugar, this can impact the health of capillaries in the retina, the light-sensitive tissue in the eye. Sometimes those capillaries will swell and leak fluid, which can impair vision. Capillaries can close off too, blocking blood supply to the retina and spurring the onset of retinopathy.
On average, it takes 15 years to go from the initial diagnosis of diabetes to blindness if it is not properly treated.
Controlling blood sugar through medication and lifestyle modifications can prevent the onset and slow down the progression of retinopathy.
William Panek, M.D., regional medical director at Blue Shield of California answers some common questions about diabetes and vision loss:
Q: Who is most at risk for diabetes-related vision loss?
A: The best predictor of diabetic eye disease and subsequent vision loss from diabetic retinopathy is the duration of the disease. The longer a
person has suffered from diabetes, the higher the risk of disease. One study showed a 27 percent risk in those who have had diabetes for 5-10 years,
and 71-90 percent in those who have had diabetes longer than 10 years.
Q: An eye exam is made up of many tests. Which tests check the retina?
A: The dilated retinal examination is the portion of a complete eye examination that involves examination of the retina for signs of
diabetic retinopathy. Special instruments (ophthalmoscopes, special contact lenses) are used to carefully evaluate this sensitive tissue for
signs of disease or progression.
Q: What are the treatment options for diabetes-related vision loss?
A: A great deal of research has been done on the management of diabetic retinal disease. Treatment involves a combination of continued blood sugar control, laser therapy, and in advanced cases, vitrectomy (the removal of the gel within the eye). If people with diabetes have
routine eye exams and the recommendations for treatment outlined in The Early Treatment Diabetic Retinopathy Study by the National Eye Institute are followed, the risk of severe visual loss in diabetic retinal disease decreases significantly.
Q: How can an eye exam give clues to one's health outside of the eyes?
A: An eye examination includes many clues about the whole body, including findings involving a portion of the nervous system (eye movements, pupil
reaction, field of vision testing) and findings involving the small blood vessels and capillaries that could reflect systemic vascular or