Eyes on the Prize: Early Detection and Management of Diabetes

When does a visit to the eye doctor mean more than just a new pair of glasses and a change in prescription? When it can change—or even save—your life.

Most people associate routine diabetic healthcare with an endocrinologist and a primary care physician, but your optometrist has the upper hand when it comes to detecting diabetes and its numerous complications at the earliest stages.

Eye Doctors See It First

What gives eye doctors the advantage? The eyes are the only places in the body where an unobstructed, noninvasive view of blood vessels is possible. By examining the cornea, the retina, and the blood flow through the vessels in, around, and behind the eye, optometrists can detect signs of numerous health conditions before they manifest themselves elsewhere in the body. High cholesterol, high blood pressure, heart disease, and diabetes, among others, all cause notable changes in the eye, including vessel leakage, retinal swelling, fatty deposits on the retina, and other changes that can be identified during a thorough eye examination by a trained eye doctor.

For this reason, comprehensive eye examinations by qualified service providers such as Vision Service Plan (VSP) in Rancho Cordova, California, are more than just a basic test to see if you need glasses. They are critical in the early detection and ongoing management of diabetes. Not only do these exams give eye doctors a first glimpse of potential, long-term health problems, but they also help optometrists spot new cases of diabetes, pre-diabetes, diabetic retinopathy, and high blood sugar levels in patients who come in anticipating a routine or annual eye examination. Following the initial diagnosis, VSP doctors refer these patients to their primary care physicians and/or endocrinologists for the necessary follow-up and preventive care.

“Early detection of diabetes has several benefits,” says Dr. Ken Johnson, a VSP-trained, private practice Doctor of Optometry in Phoenix, Arizona. “If the diabetes is recognized sooner, it can be treated sooner. This leads to a longer life, a better quality of life, and lower medical-related costs over the life span of the patient.”

Inexplicable Changes in Vision

Dr. Johnson should know. He is keenly aware of the value of comprehensive eye examinations in the detection and treatment of diabetes. A diabetic for over 20 years, he was initially diagnosed through an eye examination when he began experiencing inexplicable changes in his vision. “Most patients we diagnose come to us because of a sudden change in vision. Maybe their vision is blurry, and they have never worn glasses, and they are concerned. We are often the first doctor they see. We end up being the ones who determine they have diabetes and refer them to other medical experts for follow-up treatment.”

Don’t be misled into thinking that comprehensive eye examinations are used only for diagnostic purposes, however. The effects of diabetes damage various parts of the body, and this damage is evident in changes to the blood vessels in your eyes before other complications can be detected by a doctor.

Research by The National Eye Institute estimates that 4.1 million people over the age of 40 currently suffer the effects of diabetic retinopathy, and it projects that number to be around 7.2 million people by the year 2020. With annual comprehensive eye examinations, however, 90 percent of all diabetes-related blindness can be prevented.

New device gives advance notice

As an adjunct to the traditional optometrist-administered eye exams, a device recently created by two scientists at the University of Michigan’s Kellogg Eye Center holds great promise in giving even more advance notice of diabetes and related vision complications. The screening device takes a specialized photograph of the eye that reveals metabolic stress and tissue damage, two precursors to diabetes. The device measures specific characteristics of retinal tissue to determine the extent of the damage and potential eye disease. Not only is the retinal imaging available to diagnose diabetes, but it also has the potential to monitor the severity of retinopathy in diabetic patients.

The importance of comprehensive eye exams in the early detection and ongoing management of diabetes cannot be overstated. It is no longer enough to simply know that you have diabetes. You need to understand how it affects your entire body and impacts your overall health. “Everybody has to get on the same page when it comes to treating the person with diabetes,” says Dr. Johnson. “From the eye doctor, the dentist, the podiatrist, and the family doctor to the endocrinologist, we all have to know what’s going on with the patient, and the patient needs to understand the ramifications of the disease.” Getting a head start on diabetes through a yearly comprehensive eye examination can help reduce diabetes-related damage to the body and prevent a variety of accompanying problems, helping diabetics lead happy, healthy, and fulfilling lives in control of their disease.

Equal Access to Eye Care for Everyone

One source of eye care is VSP Vision Care, the largest not-for-profit managed vision care company in the United States, covering 55 million members, 30,000 clients, and a network of 25,000 doctors. Since 1997, VSP has donated nearly $100 million to provide 470,000 low-income, uninsured children with free eye exams and glasses. VSP promotes the importance of annual eye exams for maintaining eye health and overall wellness through relationships with the American Diabetes Association, Prevent Blindness America, and the Center for Health Transformation.

The company stresses the significance of preventive examinations and focuses on early detection and ongoing management through their private practice doctors. Everything from eye muscle coordination and peripheral vision to refraction and glaucoma testing are part of the standard examination. VSP network doctors are highly trained in recognizing early signs of diabetes and pre-diabetes and are certified by the National Committee for Quality Assurance (NCQA), a national, not-for-profit organization dedicated to improving healthcare quality. In addition, VSP eye doctors are therapeutically certified to use pharmaceutical agents in their examinations, which sets a higher standard for care in the VSP network.