November, 2009, is American Diabetes Month. In my effort to support American Diabetes Month, there are a few things that every doctor should know about diabetic eye disease. The list is short and very direct. Please share this with others; especially your doctors.
I have been in practice since 1993. As a retina specialist, I take care of patients with diabetic retinopathy. There was a “movement” to stamp out blindness from diabetes by the year 2000. While we have dramatically reduced the rate of blindness as of 2007, in fact, with early detection most patients with diabetes are unlikely to suffer severe loss of vision (clic for recent post), there are still far too many people losing vision.
Most people are simply not getting to the eye doctor. Most doctors are still not aware that patients with diabetes should get regular dilated eye exams (with the pupils dilated)!
What I believe every doctor should know about diabetic eye disease;
1. Every patient with diabetes needs a dilated eye exam once a year. Even if the patient has no symptoms. Remember that vision has no correlation with the severity of disease. I hear from too many patients that they were not referred by their doc because they had no complaints of blurry vision. Don’t wait for symptoms!
2. Diabetic retinopathy is not a result of poor sugar control. While sugar control may influence the diabetic retinopathy, the duration of the disease is the clearest predictor of developing eye disease. Okay, in English, the longer that a patient has been diagnosed with diabetes, the greater the chance of developing eye disease.
3. Diabetic eye disease may be inevitable. This is a corollary to #2. While no one knows if this is absolutely true, almost all patients with diabetes do develop the disease. I have seen only a handful of patients in over 16 years that have no evidence of the disease despite having diabetes for over 25 years.
4. Having diabetic retinopathy does not mean loss of vision. In fact, the earlier a patient is diagnosed, the less likely there will be severe loss of vision.
Spread the word! Diabetic eye disease may be inevitable, but the visual prognosis is excellent. Early detection is the key!
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist