For Your Eyes Only

I am devoting this month’s column to themost important sight-saving informationthat you should know as a person living withdiabetes.

See an Expert in Diabetic Eye Disease

Diabetic retinopathy is the leading causeof blindness today in the United States. Thebest way to prevent this disease is to havea dilated eye exam at least once a year bya medical eye specialist who has expertisewith the eye problems related to diabetes.

Simply having your eyes examined annuallyby an ophthalmologist can lessen or preventyour chances of going blind or becomingvisually impaired. If everyone with diabetestook this simple step, the incidence ofblindness would be a fraction of what it istoday.

An ophthalmologist with special training indiabetic eye disease (diabetic retinopathy)is the best person to care for your eyes—especially if you have any history of eyeproblems. Although some optometrists orother caregivers might notice the early signsof diabetic retinopathy, most do not havethis kind of expertise.

It is important to detect the early changes inthe eye caused by diabetes, because thereare many measures that one can take toprevent the progression to blindness.

How Laser Therapy for DiabeticRetinopathy Can Help

One of the biggest recent advances indiabetes therapy is the development andavailability of laser therapy for the treatmentof diabetic retinopathy. (Don’t confuse thistype of laser therapy with the laser surgeriesfor correcting vision so people can see wellwithout glasses or contact lenses.)

Put simply, the ophthalmologist directs anextremely fine, precise laser beam at the eye,and the energy generated by the laser worksto coagulate (or seal up) the leaky bloodvessels caused by the disease. Laser therapymust be done in the early stages of diabeticretinopathy, before the abnormal bloodvessels break and long before there are anynoticeable eye symptoms.

It is important understand that peripheraland night vision may be diminished afterextensive laser therapy—a small price to payto prevent total blindness.

What Is Diabetic Retinopathy?

Diabetic retinopathy is caused by years of excessivelyhigh blood glucose levels. The retina is the structure ofthe eye that is damaged. Diabetic retinopathy results inthe development of new blood vessels in an attempt tosupply more oxygen-rich blood to the damaged retina.However, these new blood vessels are fragile and breakeasily. When they break, they bleed into the center of theeye. When blood inappropriately enters this liquid cavity,it becomes cloudy and vision is impaired.

If You Have Diabetic Retinopathy… Some Steps You Can Take to Prevent Blindness

  • Get your blood glucose levels under the best controlpossible (A1C less than 7%; ideally less than 6.5%).
  • Make sure that your blood pressure is in normal ranges(less than 130/80).
  • Visit an ophthalmologist who specializes in diabeticretinopathy as often as required, but at least oncea year.

An Exciting New Development for the Eye

New medications that may help prevent the progression ofretinopathy are being developed and tested.

The most promising new drugs are called protein kinaseC (PKC) inhibitors. PKC inhibitors may not only preventor reduce retinopathy, they may also be protective to thenerves, kidneys, heart and blood vessels. Clinical trialsare ongoing.