Diabetic retinopathy is the leading cause of blindness in the United States population in people under the age of 60. The prevalence of diabetes is approximately 29 million or 9.3% of the U.S. and most concerning, around 8 million of those are undiagnosed. According to the American Diabetic Association, as of 2012 there are 86 million Americans who are classified as pre-diabetics. Pre-diabetes as of 2012 there are 86 million Americans who are classified as pre-diabetics. Pre-diabetes means your glucose levels are higher than normal, but not high enough to be classified as diabetes. Without treatment, pre-diabetics are likely to progress onto diabetes within 10 years. The above statistical information solidifies the importance of proper diagnosis and care for all diabetics.
The eye is one place we see diabetes effecting the body and therefore necessitates a yearly thorough eye exam. In fact, the American Diabetic Association, National Institute of Health (NIH), and American Optometric Association all recommend yearly DILATED eye examinations for all diabetics. Dr. Ayre takes this threat seriously and is dedicated to remaining diligent with early diagnosing, management, and ongoing communication with your primary care doctor or endocrinologist with its management.
The concern we have with the eyes and diabetes is diabetic retinopathy, as well as glaucoma. Approximately 28% of the diabetic population suffer from diabetic retinopathy, and many of them are unaware. Something equally concerning is that patients with diabetes are 40% more likely to develop glaucoma, another sight-threatening disease. We understand dilation can be inconvenient for patients, but we strongly believe this gives us the best opportunity to identify diabetic retinopathy at its earliest stages.
In patients with diabetes, we see a weakening of the walls of the retinal blood vessels, resulting in very tiny hemorrhages (microaneurysms) in the beginning stages. As the retinopathy progresses, we can also see new blood vessel growth as well as fluid buildup within the macular area of the retina. The good news is our doctors are trained and dedicated to detecting these retinal changes at the earliest stages possible. With diet changes and tighter glucose control, many of these changes are temporary and reversible.
At the offices of Dr. Doug Ayre, we are committed to providing the most advanced equipment available in the industry, which aide us in the ability to identify retinal changes as soon as possible. These include high magnification retinal photography, optical coherence tomography (OCT), and electroretinography (ERG). Results of a five-year National Institute of Health study indicated an ERG scan can detect retinal changes approximately eight years sooner than traditional methods. Just as the EKG detects early problems in your heart, the ERG does the same for the eye.
In the early stages of diabetic retinopathy, patients are typically symptomless and this further impresses the necessity for a dilated eye examination. As the disease advances, these would be a few of the symptoms you might notice:
Impaired color vision
Dark empty areas in your vision
Spots or dark strings in your vision (floaters)
It is also important to note that diabetes affects the crystalline lens inside of your eye. If your glucose levels are too high, the result will be a swelling of the lens inside your eye and a fluctuation of your spectacle prescription. Therefore, it is extremely important to have your A1C below 7 and glucose levels in a normal range, should you consider purchasing and new eyewear.
Be prepared to bring your primary care provider and endocrinologist’s information to your appointment along with medications and dosages as well as your last A1C readings. If driving while dilated is a concern for you, be sure to schedule your appointment on a day in which you can schedule a family member or friend to drive you.
Know that our doctors are fully dedicated to early detection and management of this disease and will work hand in hand with the current team of providers you already have in place.