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Diabetic Retinopathy Continued

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As November is diabetic retinopathy month, I want to continue sharing information about the condition. Let me repeat that diabetic retinopathy is the number 1 cause of new cases of blindness for adults 20-70 years old. The increasing number of people with diabetes means the number of people who will develop diabetic retinopathy will also increase. This is significant because severe vision loss can be prevented 90% of the time.

It is my job as an optometrist to identify and detect diabetic retinopathy. When I see diabetic retinopathy in a patient I have to decide when to refer for further evaluation and/or treatment

PREVENTING VISION LOSS

Have a dilated eye examination every year if you are diabetic.
If you notice changes in your vision or it seems blurry, call your eye doctor immediately.

TREATMENT

If I think treatment is indicated, I will refer you to a retinologist. A retinologist is an ophthalmologist, who treats conditions of the vitreous and retina, both effected by diabetic retinopathy. He or she will chose the best treatment option.

  • A laser may be used to stop blood vessels from leaking. It may also be used over a larger part of the retina to reduce the growth of abnormal blood vessels. Laser maintains sight, but the side effects can include, blind spots in the vision and reduced vision.
  • Corticosteroid injections into the eye provide a temporary treatment. To maintain control of the retinopathy, repeated injections are necessary every 6-8 weeks. The continued use of corticosteroids increases the risk of developing cataracts and glaucoma.
  • Another treatment is the injection of anti-vascular endothelial growth factor (anti-VEGF) to prevent the blood vessels from leaking. This treatment also needs to be repeated every 6-8 weeks.
  • The retinologist will often use a combination of the above treatments.

Researchers are looking for therapies with long-term results and minimal side effects.

Diabetic Eye Disease

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1. True or False? People who have good control of their diabetes are not at risk for diabetic eye disease.
2. True or False? Diabetic eye disease usually has early warning signs.
3. True or False? Cataracts are common among people with diabetes.

Complications from diabetes can affect many systems in the body, such as the heart and kidneys. Diabetes-related eye diseases can also affect vision. Diabetic retinopathy accounts for 12 % of all new cases of blindness each year for people between 20 and 74 years of age. While there are other eye complications associated with diabetes, I am discussing diabetic retinopathy here because patients are often not aware of it until quite late in its progression. By then vision can be lost permanently.
In diabetic retinopathy the blood vessels in the back of the eye leak fluid or blood, which seeps into the retina and causes it to swell. Retinal blood vessels may also close, preventing blood and nutrients from reaching areas of the retina. This causes those areas to die. New blood vessels may grow to compensate for the closed blood vessels, but they always bleed and create scarring. The scarring may even cause the retina to detach or wrinkle.
Early detection and appropriate treatment significantly reduces the risk of vision loss from diabetic retinopathy. Diabetic patients should perform an easy vision test every day to detect subtle changes in their vision. However this is not a complete guarantee that the eyes are healthy. Symptoms of diabetic retinopathy are usually not obvious until the advanced stages. Pain, blurred or shadowy vision, and redness may only occur when treatment is more difficult and less successful. A variety of laser treatments and injections may be used in order to prevent further vision loss. Treatment is more successful if started early at the first signs of retinopathy. These signs are detected with a dilated eye examination.
Not everyone with diabetes develops diabetic retinopathy, but the chances increase after being diabetic for several years. In fact, sometimes the diagnosis of diabetic retinopathy leads to the diagnosis of diabetes. Evidence also suggests that such factors as pregnancy, high blood pressure and smoking may cause diabetic eye disease to develop or worsen.

To help prevent the development of diabetic retinopathy and minimize vision complications:
 Take prescribed medications as instructed.
 Follow a proper diet
 Exercise regularly
 Perform a simple visual test daily
 Have your eyes examined annually

Answers to quiz:
1. False; good control of blood glucose is very important in over-all management of diabetes, but may not prevent diabetic eye disease. All people with diabetes should have an eye examination through a dilated pupil.
2. False; often there are no early warning signs of diabetic eye disease. Vision may not change until the disease becomes severe.
3. True; people with diabetes are twice as likely to develop cataracts and to develop them at an earlier age than those without diabetes.

What is Diabetes?

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November is Diabetes Eye Disease Month.  Before discussing how diabetes effects the eyes, I want to begin with the disease itself. Approximately 16 million Americans have diabetes. Classified as a “chronic disease epidemic” by the Centers for Disease Control and Prevention, the prevalence of diabetes has increased dramatically over the past forty years.

The term “diabetes mellitus” refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it is the main source of energy for the cells that make up your muscles and tissue. Glucose comes from two major sources: the food you eat and your liver. During digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.

There are different classifications of diabetes. 2 types are potentially reversible. Prediabetes is defined by having blood sugar levels that are higher than normal, but not high enough to be classified as diabetes and gestational diabetes, which occurs during pregnancy. Chronic diabetes conditions include type 1 diabetes which is caused when your immune system attacks and destroys the insulin-producing cells in the pancreas and type 2 diabetes which is caused when your cells become resistant to the action of insulin and sugar builds up in your bloodstream.

Diabetes is a chronic, complex and destructive disease that can cause a wide range of problems including heart disease, kidney failure, amputations and blindness. Both types of chronic diabetes, Type 1 and Type 2 are serious diseases, and can lead to the same kind of complications. But people with diabetes can take several steps to stay well. Most important are eating a healthy diet, exercising regularly, maintaining close control of blood sugar levels, and learning as much as possible about living with diabetes. By taking care of yourself through diet, exercise and special medications, diabetes can be controlled.

Amazing Eye Facts

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Ostrich EyesImpress your friends with these amazing eye facts.

  • An owl can see a mouse moving more than 150 feet away, with light no brighter than candlelight.
  • Mosquitoes can see into the infrared range, so humans appear to light up to them, even in the dark. To a mosquito at night, you look like a neon diner sign!
  • An ant has two eyes, each of which is made up of many smaller eyes. This type of eye is called a compound eye.
  • A worm has no eyes at all.
  • A chameleon’s eyes can look in different directions – at the same time!
  • An owl can see a mouse moving more than 150 feet away, with light no brighter than candlelight.
  • An ostrich eye is only two inches across, but it weighs more than its brain.
  • The giant squid has the largest eyeball on the face of the earth. At 18 inches across, it’s about the size of a beach ball.

Contact Lenses for Halloween

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cosmetic contact lensesDo you think a change of eye color or a pair of WildEyes will help you create the perfect Halloween costume? Use caution with these lenses. In 2005, the United States Food and Drug Administration (FDA) classified all contact lenses, whether they correct vision or are used simply for cosmetics as medical devices. In the US, contact lenses cannot be obtained legally without a prescription. Not only do the lenses have to be FDA approved, but so do the dyes. Any product in your eyes or touching your eyes should always be dispensed with a current prescription from your eye doctor. Without proper fitting and care there is a risk of bacterial infection, corneal abrasion and corneal ulcers. Don’t risk your eyesight, if you are interested in colored contacts give the office a call.

Eyeglass Event

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This Saturday Westside Optometry is hosting a special designer eyewear event. Stop by the office  between 10 and 2. There will be refreshments and a drawing for free lenses. Come by to try on frames from Max Mara, Liz Claiborne, Georgio Armani, Gucci and Saks Fith Avenue. This is an opportunity to see frames we do not ordinarily have available, and also to see all the colors and sizes of many different frames.

3-D Movies

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Binocular Vision Problems
Not everyone enjoys 3-D movies. Some viewers do not see the three dimensional effect and others may experience headaches, blurred vision and dizziness. These symptoms are common side effects for a person with binocular vision difficulties.

The 3-D effect is created by placing one image on one eye and another image is placed on the other eye. The polarized glasses are required to keep the images separate. People with binocular vision problems will not perceive the illusion of 3-D, and some will experience a “visual hangover.”

Several different visual problems could be the cause of the problem:
• Amblyopia or lazy eye. This occurs when one eye does not see as well as the other.
• Strabismus or crossed eyes. One eye does not line up in the same direction of the other eye.
• Convergence Insufficiency. The eyes are unable to turn inward simultaneously to fix a target at the same distance.

Some of the above problems can be corrected with glasses or contact lenses, patch therapy and vision training.

Dilation

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A comprehensive eye examination includes pupil dilation. Using eye drops, the pupil is temporarily and painlessly enlarged to increase the view into the eye. This gives me the opportunity to thoroughly examine the structures inside the eye: optic nerve, blood vessels, macula and retina. With the pupil dilated, I can get a 3-dimensional view and better evaluate the eye for changes or the potential for problems. The effect lasts up to 4 hours and will reduce the ability to focus on near objects. It will be helpful to bring sunglasses and make arrangements accordingly.

Eye examination

Vision Test Should be the First Exam Students take this Year

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To give your child a head start to a successful school year, educate yourself on the relationship of healthy eyesight and classroom performance.

Since 80% of a child’s learning is visual, a child’s ability to clearly see the blackboard and words on the page is critical. Many children do not know they have a problem because they think how they see is how everyone else sees. Unfortunately, some students who are labeled as having a learning disability or behavioral problems may simply have a vision impairment.

One in four school-age children have some form of vision problem. A child should not need to start failing in school before we realize there is a problem. Put “eye examination” on your back to school list.