Diabetes affects the small blood vessels of the retina, and this is known as diabetic retinopathy. Diabetic retinopathy is the leading cause of new cases of legal blindness among working-age Americans. Nearly 30% of Americans with diabetes aged 40 and older will have diabetic retinopathy to some degree. Diabetes is increasing in prevalence and is now present in 11% of Americans over the age of 20, and about 1/3 are not even aware that they have it. Fortunately, with modern and timely ophthalmic exams and treatment, 90% of severe visual loss from diabetes can be prevented.
There is general agreement that duration and severity of diabetes are major risk factors for developing retinopathy. The HbA 1c should be maintained around 7% to help lower the risk of retinopathy, especially if early retinopathy is noted on eye exam. Controlling blood pressure, cholesterol, and weight are also important in minimizing diabetic eye disease. It is critical that patients work closely with their primary care physician and their eye doctor to help minimize the visual loss that can occur with diabetes.
It is recommended that patients with diabetes have a dilated eye exam every year, and more frequently if moderate retinopathy is noted. All of our doctors are trained to evaluate diabetic patients carefully for the earliest signs of diabetic retinopathy and will communicate these results to your primary care physician. Early signs include tiny hemorrhages and exudates from leaking vessels. The leakage can lead to swelling of the macula (the central part of the retina that gives us our reading vision). We are fortunate to have Dr. Daniel Will, a trained retina specialist and surgeon, who can capably manage the retinopathy right in our office if it should progress. Treatment can include laser therapy, injections, and sometimes surgery.
The bottom line: make sure you get checked for diabetes. If you have it, work closely with your primary care physican and get a thorough, dilated eye examination at least every year. Your vision is worth it.