Today’s post is about one of my own observations from over 15 years in practice. While it is a fact that significant vision loss from diabetes is declining, it is not widely known that there is also a very finite time where patients with diabetes can go blind, there is only a finite time while the risk of blindness is highest. In short, the chance of a diabetic patient going blind these days is much less than 0.5%, especially when under the care of an eye doctor.
Let me explain. Recently, I wrote about the decline in the incidence of diabetic patients going blind. The statistics say that severe vision loss was reduced to about 0.3% by 2005-2007 (read the article “Vision Problems in Type I Diabetes on the Decline”). This is truly great news.
I have two observations; 1) I have never had a patient with diabetes go blind if I had been following them before they developed any complications from proliferative diabetic retinopathy, and 2) in most cases, when patients develop signs of proliferative diabetic retinopathy, the retinopathy usually becomes controlled within a year and becomes stable. This means they are highly unlikely to lose vision or to go blind. The patients that have gone blind usually wait until they have lost vision before seeking medical attention.
What does this mean? There are two major points. My observations are consistent with published data that correlates early detection of diabetic retinopathy with an excellent long term visual prognosis. In other words, the earlier we can detect diabetic retinopathy, the better chance that you will never lose vision. Second, there is a small window of a year or so (my personal observation) that patients are susceptible to vision loss once proliferative changes are noted. Once diagnosed with proliferative diabetic retinopathy, a patient is NOT destined to loss of vision or blindness.
So, chances are that most diabetics will not lose vision. We are stressing early examination to detect diabetic retinopathy early. Last, diabetics are not a ticking timebomb; waiting for blindness to ensue.
It’s really good news that seems to get lost in this information gap.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist