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When have you received your last eye examination?

Written by: John Kriak, PharmD Rite Aid Pharmacist and Diabetes Care Specialist at Rite Aid Store 4676 in Johnstown PA

Because diabetes is associated with a number of long-term complications, maintaining blood glucose levels in the recommended range and self care is very important. When blood glucose levels remain above normal levels for too long, eye problems, such as diabetic retinopathy may occur. Elevated blood glucose levels can damage the small blood vessels (capillaries) that nourish the retina of the eye resulting in retinopathy.¹

Diabetic retinopathy is classified as either nonproliferative or proliferative. Nonproliferative retinopathy is less severe and more common. Mild nonproliferative retinopathy does not result in vision loss and usually is not associated with any symptoms. Although this type retinopathy does not need treatment, it is important to follow up with an eye care specialist at least yearly to make sure it doesn?t get worse. Mild nonproliferative retinopathy can progress to severe or proliferative retinopathy if blood glucose levels remain above normal and annual eye evaluations are not obtained. Such severe forms of retinopathy may result in vision loss or even blindness²; in fact, diabetic retinopathy is the leading cause of blindness in people 20 to 74 years of age.^3,4

The chance of developing retinopathy is closely related to the number of years one has diabetes and how well controlled blood glucose levels are maintained.^2,4 It has also been shown that high blood pressure can increase the risk for developing retinopathy.⁵ For these reasons, it is recommended that all people with diabetes receive a comprehensive eye exam when they are diagnosed with diabetes and every year thereafter. Because pregnancy can worsen eye problems, it is also recommended that women planning on becoming pregnant, receive an eye exam prior to conception and in the first trimester.⁴ An ophthalmologist or eye care specialist may recommend more frequent follow-up eye exams if advancing retinopathy is discovered.

Annual eye examinations are very important, since there are now treatments available that can prevent vision loss. Photocoagulation (a type of laser therapy) or surgery are used to treat diabetic retinopathy and are most successful in the earlier stages of retinopathy before there is vision loss. Eye examinations are also useful in diagnosing other eye complications for which diabetes can increase your risk, such as glaucoma and cataracts.¹

In summary, the key to preventing the development of eye problems, such as diabetic retinopathy, is to maintain good blood glucose control as well as to effectively integrate proper diet, exercise, medications, and self care into your diabetes care plan.

References:

1. Funnell M. Eye Disease and Adaptive Diabetes Education; A Core Curriculum for Diabetes Education 3rd Edition, ADA: 681-706.
2. Ciulla TA, Amador AG, and Zinman B. Diabetic Retinopathy and Diabetic Macular Edema. Diabetes Care. 2003; 26: 2653-2664.
3. American Diabetes Association. Diabetes facts and figures. Available at: http://www.diabetes.org. Accessed June 28, 2004.
4. Fong DS, Aiello L, Gardner TW, et al. Retinopathy in Diabetes. Diabetes Care. Diabetes Care. 2004; 27: S84-87.
5. UK Prospective Diabetes Study Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 708?713.

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