Of the approximately 14 million Americans with diabetes, almost half have some form of diabetic eye disease. Diabetic eye disease is the leading cause of new blindness among working age adults in the United States. Despite this, rates of annual eye examinations among persons with diabetes remain low. Increased awareness of the sight-saving benefits of annual eye examinations through dilated pupils is important in reducing the significant social costs and personal tragedy of diabetic eye disease.
Diabetic eye disease refers to a group of sight-threatening problems that people develop as a complication of diabetes. They include:
- Diabetic retinopathy-damage to the blood vessels in the retina, the light-sensitive tissue in the back of the eye that translates light into electrical impulses that the brain interprets as vision.
- Cataracts-clouding of the eye’s lens
- Glaucoma-an increase in pressure inside the eye that leads to optic nerve damage and loss of vision.
Diabetic retinopathy is the most common eye disease among persons with diabetes and may produce no symptoms until it is too late. Cataracts and glaucoma also affect many people without diabetes but occur twice as frequently among persons with diabetes. These are serious problems that can lead to loss of sight. They may be developing even when your sight is good. If you’re having trouble reading, if your vision is blurred, or if you’re seeing rainbows around lights, dark spots, or flashing lights, you may have reason for concern. Ask your healthcare provider to refer you to an eye doctor who cares for people with diabetes.
What can be done to prevent or delay the development of these complications? There is a lot an individual can do to “take charge” and prevent problems with their eyes. A recent study shows that keeping your blood sugar levels as close to normal as possible can prevent or delay the development of diabetic eye disease.
Another “must” is getting a comprehensive eye examination through dilated pupils every year. Regular, complete eye exams, even when you’re seeing clearly, are important to protect your sight. If you haven’t already had a complete eye exam, you should have one now if any of these things apply to you:
- You have had type I diabetes for five or more years.
- You have type 2 diabetes.
- You are going through puberty.
- You are planning to become pregnant.
Because diabetic eye disease often has no early symptoms, it is only detected during a comprehensive eye examination. Before the exam a doctor (opthamologist) or nurse will put drops in your eyes to dilate or enlarge the pupils. By doing so the opthamologist can better examine the back of the eye for early signs of disease before noticeable vision loss occurs. After your first exam, you should have a dilated eye exam once a year. Keep track of these exams in your personal health records.
Laser surgery may help people who have advanced diabetic eye disease; however, laser surgery often cannot restore vision that has already been lost. Such surgery is a major advance in the prevention of blindness for those with retinopathy, but is a poor substitute for keeping the eyes healthy.
To receive more information and educational materials you can write to the National Eye Institute (NEI). The NEI has developed a National Eye Health Education Program to help increase provider and patient awareness of diabetic eye disease. To receive additional information, write to: National Eye Health Education Program, 20/20 Vision Place, Bethesda, MD 20892-3655, or call (301) 496-5248.
You can also write for Take Charge of Your Diabetes: A Guide for Care published by the Centers for Disease Control and Prevention. The guide has charts for keeping meal planning advice, and suggestions for major points to discuss with your healthcare provider. The guide can be obtained by writing: Centers for Disease Control and Prevention, National Center for Disease Prevention and Health Promotion, Division of Diabetes Translation, 4770 Buford Hwy., MS K10 Atlanta, GA 30341-3724.
You may also call the American Diabetes Association at (800) 232-3472 or your local American Diabetes Association office.
Information used in this article was obtained from the National Institute of Health’s National Eye Health Education Program Educating People With Diabetes Kit and from the Centers for Disease Control and Prevention, Division of Diabetes Translation Take Charge of Your Diabetes: A Guide For Care.
Editors’ note: Remember, uncontrolled blood sugars will result in blurry vision-an acute, reversible problem related to metabolic control and not to retinopathy. Retinopathy is asymptomatic until too late, in many cases.