Eye Exams Are Crucial for People with Diabetes to Detect Common Causes of Vision Loss

When is the last time you visited your optometrist or ophthalmologist? Did you know that a full eye exam including dilation of the eye is recommended starting at age 60, and starting at age 40 for African Americans?  Age-related and diabetes-related eye diseases have little to no early warning signs but can lead to vision loss or even blindness if not discovered soon enough. However, an annual dilation of the pupil, known as a dilated eye exam allows an eye doctor to see a much larger portion of the retina than looking through a pupil which is not dilated. It is a simple procedure and could save your sight.

November is American Diabetes Month, and the Qsource is focusing on eye health for people with diabetes. Diabetic eye disease is expected to quadruple by the year 2050. Diabetic eye disease is a group of problems, including retinopathy, cataracts, and glaucoma that emerge as a complication of diabetes. For diabetic retinopathy which usually affects both eyes, the eye doctor during a dilated eye exam can see swelling or leaking blood vessels or growth of extra vessels. If caught early enough, a person can have laser treatment to stop or slow down the disease process and preserve a person’s vision. Still, blood pressure and blood sugar control are keys to maintaining the vision that is left.  What about life after retinopathy has set in?

Rhonda, a former Everyone with Diabetes Counts class participant in Indiana, knows what it’s like. She has had diabetes for 10 years but noticed changes in her vision after just five years with diabetes.  Her ophthalmologist sent her to a cataract specialist to deal with cataracts, but a year later when re-visiting the cataract specialist, he noticed places on her retina that showed signs of retinopathy.

“He really scared me because he said ‘If you don’t lose this weight you’ll end up losing your vision.’ That scared the heck out of me, so I put myself on a diet and attended classes at my community hospital. She later attended Qsource’s Everyone with Diabetes Counts 6-week workshop to continue improving her self-management skills. Jill, the Qsource/Qsource peer leader, told her about another local resource which is supervised exercise classes offered twice a week at the local hospital. “They check my blood sugar before and after exercise,” Rhonda said.

Living with retinopathy takes much care. Rhonda sees her ophthalmologist every four weeks for an Avastin shot in her eye. She hasn’t noticed an improvement in her vision, but the treatments seem to be stabilizing her retinopathy, so it’s not getting worse. Her family doctor encouraged her to exercise and checks her A1C, blood pressure, and cholesterol every six months. Her ophthalmologist raves about her progress because she has lost 40 pounds through exercise and eating healthy which he thinks has helped slow the worsening of the diabetic eye disease. Note that strenuous exercise or weights may be contraindicated if someone has advanced (proliferative) retinopathy. Before starting a strenuous activity program, talk with your doctor.

Besides the retinopathy, she has macular edema, which can occur with aging or as a result of diabetic retinopathy. Rhonda’s vision is a little cloudy right in the middle, and when something she’s viewing is vertically straight, she sometimes sees it as curved in the middle. There are no current vision tools which can compensate for this abnormal vision, but she is thankful her left eye is still very healthy. Her advice to others struggling with their diabetes is to find a good doctor that is patient, has a good reputation, and has had success with their patients.

In addition to a comprehensive annual eye exam, here is what else a person with diabetes can do to prevent or help stabilize diabetic retinopathy. Stay on TRACK:

Take your medications.
Reach and maintain a healthy weight.
Add physical activity to your daily routine. Note if you already have diabetic retinopathy or glaucoma, you may have weight-lifting restrictions. Check with your doctor before starting any strenuous activity or weight-lifting.
Control your blood sugar, blood pressure, and cholesterol.
Kick the smoking habit.

*Source: https://nei.nih.gov/nehep/

The Qsource offers community-based diabetes self-management workshops for people wanting to improve in any of these areas. Contact Debra Bratton, RN, BSN, CPHQ, CPHM, to find a class near you.