Diabetic Eye Disease
by John Hyatt, M.D., Retinal Consultant and Surgeon, Retina & Vitreous Center
Diabetes, the inability to regulate blood sugar levels, is disturbingly common in the United States. Data from 2015 show that over 30 million Americans are affected, roughly 10% of the population, and that number is expected to increase by 50% by the year 2030. Though some children are diagnosed with diabetes, the large majority of diabetics develop it as adults. Childhood diabetes (Type 1) results from lack of insulin, a hormone that helps your bodymove sugar from the bloodstream into cells. In contrast, Type 2 diabetics do not respond normally to the insulin their bodies make.
The disease presents unique challenges to both patients and doctors. Early in its course, especially in Type 2 diabetes, it may not cause notable symptoms, so doctors vigilantly monitor for the onset of high blood sugar. Diabetes affects the body in several ways: it increases risk of heart attack, stroke and kidney disease. Many patients aren’t aware that it can also significantly impact their vision. Gradual damage to small blood vessels as a result of elevated blood sugar results in changes to the retina, the light-sensing nerve layer in the back of the eye. This damage is referred to as diabetic retinopathy, and it can present across a spectrum of severity, from mild to vision-threatening. Approximately one-third of adults diagnosed with diabetes have some level of eye damage, and that number is higher in those who have had diabetes since childhood.
Medical studies have shown us that good control of blood glucose postpones and limits the severity of diabetic retinopathy. When patients are diagnosed, they need to evaluate their diet and lifestyle, as well as monitor blood sugar so appropriate decisions can be made about a possible medication regimen. For some with Type 2 diabetes, changing the type and amount of carbohydrates in the diet, resuming exercise, and losing weight may control blood sugar without medications.
Because retinal problems can slowly evolve over time, diabetic patients should see their eye doctor at least annually – and more frequently if significant retinal changes are noted. Mild diabetic retinopathy may be monitored as part of periodic eye exams. Retinal swelling or growth of abnormal blood vessels inside the eye may require specialized treatment to preserve vision. If these problems are detected, patients are typically referred to a retinal specialist for treatment.
At a retinal specialist’s office, patients can expect a thorough eye examination with particular attention to the retina and its circulation. This may mean using various imaging modalities to fully determine retinal health. Fortunately, with currently available technology, these tests can typically be done in the office on the same day as the initial appointment.
Though diabetes is a tremendous health burden in the US, there are excellent strategies available to protect or improve vision in our diabetic patients. I encourage all diabetic patients to work actively with their primary care doctor to manage the disease and to maintain a regular schedule of eye exams.
For more information call Retina & Vitreous Center at 541-488-3192 or visit www.retinaandvitreous.com.