When was the last time you saw your eye doctor? Do you have diabetes? Do you have glasses? Do you have glaucoma?
These are some common questions you may be asked at a health care encounter. Your doctor isn’t asking questions for no reason. Diabetic retinopathy — a diabetes complication that affects the eyes — is the most common cause of blindness in the U.S., affecting more than half of the some 24 million people living with diabetes who are over the age of 18. Worldwide the most common cause of blindness is cataracts, which is a clouding of the lenses in your eyes.
So what is diabetic retinopathy? It is a condition that affects the retina, which is the light-sensitive tissue at the back of the eye. The most common cause is poor blood sugar control, and the condition affects people with both type 1 and type 2 diabetes. The sad thing is 90 percent of all cases of blindness from diabetes can be prevented. You read that correctly — 90 percent can be prevented.
Prevention starts with a dilated eye examination. It is important to tell your optometrist/ophthalmologist if you have diabetes so they can be aware what to look for. The recommendation for all diabetics is to have yearly dilated eye exams. Going to the optician to get your glasses prescription tested is not enough, nor is having your regular doctor do a routine eye exam. A dilated eye exam is the only way to really see the whole retina to look for damage. Only optometrists and ophthalmologists can detect these signs of retinopathy, and only ophthalmologists are trained to treat retinopathy.
Treatment involves either surgery or laser surgery. With timely treatment, adequate control of blood sugar, blood pressure, and cholesterol levels, and regular follow up, we can prevent the majority of cases of blindness.
Other things you can do to take care of your eyes and vision are the following:
Keep blood sugar levels under tight control — diabetics who do not keep their sugars under tight control get retinopathy on average four times as often as people who keep their sugars close to normal. High sugar levels can also make your vision blurry.
Bring high blood pressure under control. Not only can high blood pressure make eye problems worse, they can also damage your kidneys.
Quit smoking. Smoking affects multiple systems in the body, including the eyes.
Make sure to see your eye care professional if you develop any of the following: blurry vision, trouble reading signs or books, double vision, one or both eyes hurt, eyes get red and stay that way, you feel pressure in the eye, you see spots or floaters, straight lines don’t look straight, you can’t see things at the side as you used to.
Lastly, your doctor may have told you that you have pre-diabetes. It is very important for you to see your eye doctor as well. Pre-diabetic patients have a high risk for eye complications as well, and quite often worsening blood sugars may be picked up during a routine dilated eye examination, prompting you to seek medical treatment for the diabetes. And remember — bring your sunglasses, you will be a little sensitive to light after your examination.
Nathan Lilya is a resident physician in the final year of training at Community Health of Central Washington in Ellensburg.