By Eileen B. Wyner, NP
Bulfinch Medical Group
Everywhere I look I see evidence of the wonders of Mother Nature. All the bent over trees of winter are now lush and green. The front walks in my neighborhood are covered in bright purple and pink phlox and the Public Garden is carpeted with vibrant and brightly colored tulips. Blue jays and robins fly around the yard. Imagine for a moment what your life might be like if you couldn’t see all this beauty clearly, or even at all, with your own eyes. This situation is a reality for many people living with Diabetes. Visual impairment and blindness can occur when Diabetes is poorly controlled and Diabetes is the chief cause of blindness for people between 20 and 74 years of age.
Retinopathy is the most common eye problem resulting from Diabetes. The retina, located in the back of the eye, is the light sensing lining responsible for making the pictures of what we see. Retinopathy occurs when there is damage to the tiny blood vessels in this lining, as they may become swollen and blood may leak into the retina. There are two types of retinopathy: Nonproliferative and proliferative retinopathy. Nonproliferative retinopathy (NPR) means there is blood or fluid leaking into the retina, swelling occurs, and the retina may be deprived of oxygen. Proliferative retinopathy (PR) means the eye grows fragile new vessels that can cause visual damage and blindness.
The American Diabetes Association states in their 2011 Guidelines of Care that all patients with Diabetes should have a screening dilated eye exam (DEE) annually by either an ophthalmologist or optometrist. There are some practices that also use high quality photographs of the eye in conjunction with the dilated exam, but photos shouldn’t be used in place of the DEE. Neither NPR nor PR causes pain but both forms are progressive if not identified and treated. In fact, NPR causes no symptoms and is only identified during the screening exam. Please report IMMEDIATELY any sudden visual changes such as flashing lights, floating particles, blind spots, or looking through a veil to your eye doctor as these could represent PR and require urgent evaluation.
Prevention is the key. It is imperative to keep your blood sugar in the best possible control so work closely with your Diabetes educator and health care provider to determine the best goal for your blood sugar. It is also important to keep your blood pressure and cholesterol in good control and see your eye doctor as scheduled.
If you are diagnosed with retinopathy, treatment may include laser therapy to seal the leaking vessels and destroy abnormal vessels directly, cryotherapy to freeze the abnormal and leaking vessels, and/or surgery.
Now that you understand how to care for your eyes, schedule your eye appointment, and go treat yourself to a long look at the beauty of spring. Happy spring!!