Early detection is crucial to prevent diabetic retinopathy and protect your eyes against impaired vision.
Diabetes is the leading cause of new cases of blindness among American adults aged 20 to 74 years, according to the 2011 National Diabetes Fact Sheet issued by the Centers for Disease Control and Prevention (CDC). In fact, people with diabetes are at 25 times greater risk for blindness, while people who smoke, have poor nutrition and do not control their diabetes have an even greater risk of developing eye complications.
A common complication of diabetes, diabetic retinopathy occurs when elevated blood sugar damages the retinal blood vessels, causing them to break down, leak or become blocked. Over time, this causes bleeding and impaired oxygen delivery to the retina that can lead to the growth of abnormal vessels. These new vessels are fragile and can break easily, resulting in scar tissue that detaches the retina and causes permanent vision loss. Additionally, leaking blood vessels in the central area of the retina called the macula, which is responsible for seeing fine detail and color vision, may lead to accumulation of fluid that significantly impairs vision.
Poor blood sugar control and a longer duration of diabetes lead to increased rates of retinopathy in people with type 1 and type 2 diabetes. However, diabetic retinopathy is treatable and one of the most preventable causes of vision loss and blindness. Although early diagnosis and proper treatment reduce the risk of vision loss, as many as half of the people with diabetes are not getting their eyes examined and are diagnosed too late for treatment to be effective. Individuals with diabetes are also at an increased risk for other eye diseases, including glaucoma, cataracts, cranial nerve palsies, staphylococcal eyelid disease and dry eye.
Optometrists and ophthalmologists can provide vision aids and devices to help those who have experienced uncorrectable vision loss. These eye care professionals can also provide a full spectrum of care and services that may allow people with vision impairment and diabetes to maintain their independence and quality of life. However, the first step to preventing vision loss from diabetes is to have an eye examination, including a dilated retinal examination, with early treatment if problems are found. Oftentimes your eye doctor can see things that you cannot and may be able to detect diabetes in the eye, even if you are not diagnosed.
If you have diabetes, or any risk factors like a family history of diabetes, gestational diabetes or polycystic ovarian syndrome, are over age 45, overweight or have high blood pressure, it’s even more important for you to follow through on your annual eye exam. Quality treatments are available to prevent or stop vision loss from diabetes, but very little can be done to restore vision that has been damaged or lost. And don’t forget the fact that, along with other diabetes-related complications, most vision loss caused by diabetes can be avoided with good diabetes management (including control of blood glucose, blood pressure and cholesterol); early detection and timely treatment.
Dr. W. Lee Ball, O.D., FAAO, is a graduate of the University of Houston College of Optometry and a Fellow of the American Academy of Optometry. After a residency at the University of Miami Bascom Palmer Eye Institute, Dr. Ball joined the clinical staff at Beth Israel Deaconess Medical Center and Joslin Diabetes Center, both teaching hospitals of Harvard Medical School. He also served as an adjunct clinical faculty member at the New England College of Optometry.