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Dr. Christianson Answers Your Questions on Diabetic Eye Care

What does the diagnosis of Diabetes or Diabetic Retinopathy mean exactly? I’ve heard there are different types?

Diabetes can cause small blood vessels to leak. The eyes have many small blood vessels in certain areas, like the retina. Therefore, if Diabetes causes blood or fluid to accumulate in the retina, it’s called Diabetic Retinopathy. In late stages of the disease, new blood vessels start to grow (called Proliferative Diabetic Retinopathy), which lead to further leakages and complications.

 

In what way(s) does a diabetic eye exam differ from a regular eye exam?

A diabetic eye exam includes a detailed inspection of the retinal blood vessels. Typically, it is performed by dilating the patient’s pupils and/or using retinal imaging to document any blood vessel changes.

 

I understand that Diabetes are common among those over 40 or with weight issues. What causes it? Are there other groups that are at a higher risk?

Age is certainly a risk factor, as metabolism slows in later ages. As metabolism slows, weight gain occurs, which stresses the pancreas’s output of insulin. If the pancreas cannot produce enough insulin, then the amount of sugar in the bloodstream can damage small blood vessels in the body. Ethnicity is also a risk factor, as some develop diabetes higher than others.

 

Please describe the typical progression for an individual with Diabetes regarding their eyesight?

This question is somewhat complex, considering diabetes can affect the eyes in multiple ways. As described earlier, diabetic retinopathy can blur or distort a person’s vision depending on which area of the retina is affected. However, diabetes can also cause swelling of the natural lens (inside the eye), which leads to temporary nearsightedness and blurred vision at far viewing distances.

 

What happens during a typical Diabetic Eye Exam?

A vision exam is always performed first. If any changes in vision are noted, then we need to inspect each area of the eyes to see if diabetes has caused anatomical changes. This is done by dilating the pupils, taking pictures of the retinas, or special imaging of the eyes.

 

What treatment options and/or care is available for this condition?

Most forms of diabetic retinopathy treatment are actually counseling. We educate patients that there are no treatments other than controlling the diabetes by an endocrinologist, dieting properly, and getting regular exercise. Diabetic retinopathy can go away, especially if the patient lowers his/her diabetes by following proper instructions. In severe stages (Proliferative Diabetic Retinopathy), we treat the eyes with medicine to reduce swelling or bleeding with a retinal specialist.

 

What are the risks and side effects associated with these treatments? What if you don’t proceed with treatment?

If you don’t follow the instructions necessary to control diabetes, then the disease can get worse, leading to further eye problems. If someone has severe diabetic eye problems (Proliferative Diabetic Retinopathy), then it can lead to blindness if not treated by a retinal specialist.

 

Will a change in a patient’s diet, exercise routine, or medication help at all?

Yes. Controlling these factors are crucial. When followed properly, they can even eliminate diabetic eye problems.

 

Regardless of cost or coverage by my insurance, what are some alternative treatments?

Diabetes is controlled with diet, exercise, and medications. Annual eye exams are utilized to find problems within the eyes. There are no other alternative treatments.

 

Can you recommend a vitamin/mineral program for me that might be helpful or are vitamin supplements specific to each patient?

We always recommend a daily multivitamin, for general health. Eye supplements are not necessarily used for diabetic related issues, however they are used for other eye conditions like Macular Degeneration or Dry Eye Syndrome. There are no recommended supplements for diabetic retinopathy.