For Your Eyes Only

The following is excerpted and adapted from the book “Taking Control of Your Diabetes,” by Steven Edelman, MD, and friends, 2001

Important sight-saving information that you should know

| Apr 1, 2005

I am devoting this month’s column to the most important sight-saving information that you should know as a person living with diabetes.

See an Expert in Diabetic Eye Disease

Diabetic retinopathy is the leading cause of blindness today in the United States. The best way to prevent this disease is to have a dilated eye exam at least once a year by a medical eye specialist who has expertise with the eye problems related to diabetes.

Simply having your eyes examined annually by an ophthalmologist can lessen or prevent your chances of going blind or becoming visually impaired. If everyone with diabetes took this simple step, the incidence of blindness would be a fraction of what it is today.

An ophthalmologist with special training in diabetic eye disease (diabetic retinopathy) is the best person to care for your eyes— especially if you have any history of eye problems. Although some optometrists or other caregivers might notice the early signs of diabetic retinopathy, most do not have this kind of expertise.

It is important to detect the early changes in the eye caused by diabetes, because there are many measures that one can take to prevent the progression to blindness.

How Laser Therapy for Diabetic Retinopathy Can Help

One of the biggest recent advances in diabetes therapy is the development and availability of laser therapy for the treatment of diabetic retinopathy. (Don’t confuse this type of laser therapy with the laser surgeries for correcting vision so people can see well without glasses or contact lenses.)

Put simply, the ophthalmologist directs an extremely fine, precise laser beam at the eye, and the energy generated by the laser works to coagulate (or seal up) the leaky blood vessels caused by the disease. Laser therapy must be done in the early stages of diabetic retinopathy, before the abnormal blood vessels break and long before there are any noticeable eye symptoms.

It is important understand that peripheral and night vision may be diminished after extensive laser therapy—a small price to pay to prevent total blindness.

What Is Diabetic Retinopathy?

Diabetic retinopathy is caused by years of excessively high blood glucose levels. The retina is the structure of the eye that is damaged. Diabetic retinopathy results in the development of new blood vessels in an attempt to supply more oxygen-rich blood to the damaged retina. However, these new blood vessels are fragile and break easily. When they break, they bleed into the center of the eye. 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 control possible (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 diabetic retinopathy as often as required, but at least once a year.

An Exciting New Development for the Eye

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

The most promising new drugs are called protein kinase C (PKC) inhibitors. PKC inhibitors may not only prevent or reduce retinopathy, they may also be protective to the nerves, kidneys, heart and blood vessels. Clinical trials are ongoing.

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Categories: A1c Test, Blood Glucose, Diabetes, Diabetes, Eye Care (Retinopathy)

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Apr 1, 2005

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