By Cheryl L. Dejewski
With diabetes at epidemic levels, chances are you know (or are) one of the 29+ million Americans with the disease. If so, be aware: Diabetes does more than affect blood sugar. Without proper precautions, it can rob a person of their sight.
“We want to give all diabetics 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 Milwaukee-area ophthalmology practice that specializes in the care of diabetic eye disease.
How diabetes affects vision
“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, where he utilizes advanced medication injection and laser treatments. “All diabetics—type 1 or 2, insulin-dependent or not—are at risk for eye complications, which can appear as early as upon diagnosis and increases with the number of years you are diabetic. Up to 45% of diabetics have some degree of retinopathy (damage to the retina). And, if you are black or Latino, you have up to a three times greater risk of losing vision to diabetes than a white person.”
Symptoms
“Usually, there are no symptoms. 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. You should also call your doctor immediately if you notice vision changes in one or both eyes, numerous floating spots (like spider webs), or a veil over your vision, or if you are pregnant,” says Daniel Ferguson, MD, a leading area eye surgeon who conducts continuing education programs for local health care professionals.
Detection
“Because blood sugar level fluctuations can temporarily affect vision and significant retinopathy can exist even if a person’s vision appears to be good, diabetes-related eye damage can only be diagnosed through a comprehensive eye exam that includes pupil dilation (enlargement with drops) to best see inside and thoroughly check the back of the eye,” explains Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins.
Treatment
“In our practice, we have had special training in the use of medication (Avastin, Eylea and Lucentis) injections into the eye to stop abnormal blood vessel leakage and growth. Results from injection treatment can be quite successful, including stabilization of vision and, in some cases, actual improvement in sight,” reports ophthalmologist Michael Raciti, MD. “For certain forms of diabetic retinopathy, however, laser treatment (alone or in conjunction with injections) is the best course of action.”
When to be screened for diabetic eye disease
Do you have diabetes? Was your last eye exam more than a year ago? If “Yes,” then it’s time to have your vision checked. Eye appointments are often covered by insurance, Medicare or Medicaid; and arrangements can usually be made to accept cash, check, credit card or financing plan payment. Optometrist David Scheidt, OD, advises, “Don’t hesitate. Diabetes-related sight loss is often preventable with 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. And, remember, EVERYONE should have their eyes checked at least every two years after age 40 for other conditions, like glaucoma, that may be causing permanent vision loss without you even noticing it.”
Ways to reduce the risk of diabetes-related vision loss
- Have a blood sugar test every three years after age 45 to screen for diabetes
- Keep blood glucose levels close to normal through diet, medication and exercise
- Don’t smoke
- Keep blood pressure under control
- Keep cholesterol levels low
- Check hemoglobin A1C levels at least every four months. Aim for less than 7.0
- Schedule dilated eye exams once a year, or as often as your Eye M.D. suggests
Diabetes can cause abnormal retinal blood vessel growth, leakage and bleeding that leads to blurring, distortion, dark spots, and loss of vision.