I had an old friend visit me this week. AB and I met when I was a young doctor in Baltimore. He was referred to me for treatment of his diabetic retinopathy. Eventually, I operated to remove a vitreous hemorrhage resulting from his proliferative diabetic retinopathy.
For several years, we saw each other twice a year. He retired about 8-10 years ago and moved to Florida. There are lots of eye doctors there!
I don’t think we have seen each other for 8-10 years. As you know, I now practice in Virginia. He found me on the Internet.
When I get to the office, I glance over the patient schedule for the day. I recognized AB’s name instantly and was excited to see him.
He hadn’t changed much. I recognized him from across the waiting room, talking with some of the other patients. He is now in his early 70’s and has had diabetes for 40-45 years.
He told me I’ve gained weight. He looked as I remembered him, that is, I couldn’t return the “compliment.”
He said he has had slow progressive loss of vision over the past 6 months. Reading road signs and watching TV had become increasingly difficult. He also griped about the last retina doc he saw in FL…didn’t like him at all.
Diabetic retinopathy can not be cured, but we are often successful maintaining status quo…provided regular checkups occur.
AB not liking his docs could have a couple of meanings; he doesn’t go back as often as he should, and/or perhaps he didn’t like the news he received from the docs.
The top possible causes? Diabetic retinopathy (specifically diabetic macular edema), poor sugar control, needs new glasses or cataracts. While there are many more causes of loss of vision, I thought these were the most likely.
After complete dilated exam, I was happy to report to him that he needed cataract surgery and, most importantly, there were no signs of diabetic macular edema nor active proliferative disease.
What Does This Mean?
Find a doctor who you trust. That’s the definition of the “best doctor.” It becomes crucial for patients suffering from long-term, or chronic, diseases such as diabetes or diabetic retinopathy. All diabetic patients need regular eye exams for diabetic retinopathy.
If you don’t like your doctor, you aren’t likely to believe what she has to say and you won’t go as often as you should. Simple human nature.
I expect AB to return to 20/20 vision after successful cataract surgery despite his age, length of being diabetic and the history of proliferative disease.
I noted his weight was stable, hinting AB is very disciplined and, unlike me, has been able to control his weight over the years. I am not sure if there is any causal relationship between good vision and stable weight/diabetic control.
My point is that the disease is not certain to cause blindness or even severe loss of vision and I wanted to share a good story of seeing well despite chronic disease…and a trusting friendship.