The Blinding Cost of Diabetes – It’s Time to Fight Back!

Do you know someone with diabetes? I bet you do. In fact, over 25.6 million Americans over 20 years old suffer from diabetes, which costs over $250 million in health care spending for Type 2 alone.

Image Courtesy of The National Eye Institute

Image Courtesy of The National Eye Institute

So why do optometrists care so much about this condition?

Well, unfortunately, diabetes is the leading cause of vision loss in working age patients. So, not only do thousands of my patients have diabetes, including my father, they are all at risk for debilitating vision loss. Considering that this condition hits so close to home for me, I have made it my mission to reach out to the community and remind everyone of the importance of a yearly dilated eye examination.

By checking your eyes, optometrists can find early changes in the retinal blood vessels. These changes can include small areas of blood and fluid leakage as well as areas that are not getting the blood they need to survive. If these changes get bad enough, new blood vessels start to grow that are even more prone to leakage. Soon, without treatment, people lose their sight. The scary part is that most of these changes occur silently and without pain until it is too late to salvage what’s left of the person’s vision. The fortunate part is that if caught early, treatment can slow and sometimes halt the progression. This problem is so important that primary care doctors are now graded on the percentage of patients they refer for a yearly dilated examination.

So please, if you have diabetes, do the following:

  1. Find the time to visit an eye care professional for your yearly examination.
  2. Show up to all of your scheduled appointments for your primary care doctor.
  3. Take your medicine!
  4. Be honest with your doctors if you are struggling.
  5. Exercise in any safe manner.  Do what interests you.
  6. Know your number!  Check your blood sugar and ask your doctor for a goal.
  7. Study and eat a proper diabetic diet.  That does not just mean not eating sweets.  Ask a dietician or your doctor for advice.

Look, I know from personal experience that it is easier said than done, but keeping up with these seven principles can save your vision and extend your life.  Also, if you have a family member with diabetes, please help me spread the word!

Thank you,

~ David C. Ardaya, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

Vision and the aging eye

Courtesy of ORBIS US on Flickr

Courtesy of ORBIS US on Flickr

Many patients reach a certain life stage and realize they need to start thinking more about their vision and preventing eye problems.  This usually happens in their early to mid-forties when people notice reading is a lot easier when there’s plenty of light and the print is held further away.  Those who have seen an eye care provider for this problem should have already discovered that this is a normal aging process.  But how does one know when vision changes are normal or should be concerning?

Eye conditions that impact vision:

  • Presbyopia is the medical term for when the focusing muscles in the eye are not as flexible, causing poor focusing ability for objects nearby.  This typically occurs in the late thirties/early forties and is easily corrected with reading glasses or bifocal or progressive lenses.
  • Cataracts begin to develop in our forties and progress over time.  There is a natural clear crystalline lens in our eye which focuses light onto our retina.  With ultraviolet ray exposure, this lens can become more opaque and yellow over time, causing a dimming of vision and glare and haloes around lights.  The best way to prevent cataracts from progressing quickly is to protect the eyes with UV-blocking sunglasses anytime you are outdoors.  The good news about cataracts is that they can be easily removed and replaced with an artificial lens implant.  With the latest technology of intraocular lens implants such as muiltifocal lenses, patients are now able to see clearly at all distances without the use of glasses or reading glasses.
  • Glaucoma is a symptomless eye disease of the optic nerve head where the nerve slowly deteriorates over time.  Most patients who develop glaucoma will not have any symptoms until the late stages of the disease, when peripheral vision deteriorates and patients are left with tunnel vision.  There is no cure or preventative measure for glaucoma, however, it is easily treated with eyedrops.  The only way to determine if you have glaucoma is to have annual comprehensive eye examinations.

    Courtesy of Nargopolis on Flickr

    Courtesy of Nargopolis on Flickr

  • Macular Degeneration is another common eye disease that can cause debilitating vision loss.  This occurs when the macular region of the retina loses its integrity causing poor central vision with distortion or gray spots.  It is often detected upon routine examination, especially when photos of the retina are compared over time.  Fortunately, there have been extensive studies on macular degeneration and the field has changed dramatically over the last several years.  An important test in recent years is genetic testing to determine one’s risk factor for vision loss as a result of macular degeneration, as well as antioxidants that may be useful in reducing this risk.  Clear risk factors include a history of smoking, exposure to ultraviolet radiation, increased cholesterol levels and Caucasian women with lighter eyes and fairer complexions.
  • Retinal Detachment tends to occur more often in those who are older than 65.  The retina is a thin and fragile tissue that lines the back wall of the eye and sends visual information to the brain.  This tissue becomes more fragile over time and can easily develop a hole or tear leading to a retinal detachment.  If you experience flashes of light, new floaters, or a change in your vision, you need to be seen right away by your eyecare provider.

There are a myriad of eye conditions that can develop as one ages.  The most important and useful method of preventing vision loss is to stay healthy.  See your primary care physician regularly to evaluate and treat high blood pressure, high cholesterol, diabetes and other health conditions.  If you have uncontrolled health conditions, you can easily lose your vision to diabetic retinopathy, hypertensive retinopathy, or a stroke in the eye.

So, as I tell all my patients, see your physician regularly, eat green leafy vegetables, take your medications, and monitor your own blood pressure or blood sugar.  And of course, wear sunglasses outdoors and see your optometrist annually.

~Cindy P. Wang, OD, FAAO
California Optometric Association
http://www.coavision.org