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Jennifer sat
in the ophthalmologist's office crying.
She had been helping
 blow
up balloons for her 1-year-old niece's
first birthday party. The vision in
her eye had just turned totally red and
dark while she was inflating her second
balloon.
Jennifer, a
diabetic since childhood, is now 30 years
old. She has taken insulin for 20 years.
Her last "checkup" was her vision exam to
get her driver's license at 16. She had
been a rebellious teenager who did not
control her diet, weight, or insulin, and
she had stopped having her eyes checked
except to get her contact lenses replaced
every few years. The doctor now found
that Jennifer had diabetic changes in both
eyes and that one blood vessel had
ruptured. Jennifer received treatment,
regained her 20/20 vision, and has had
yearly evaluations for the past 10 years
without recurrent bleeding.
What Jennifer
did not know, until her emergency, was
that diabetes is the leading cause of
preventable blindness in America.
Sometimes people with diabetes have
progressive blurred vision or, what is
even more frightening, can wake up with
dark red vision without realizing anything
has gone wrong; diabetics have no eye
pain, no pus, and no bloodshot eyes as a
warning. Like Jennifer, patients with
diabetes can have 20/20 vision until the
day they suddenly lose their sight. Every
diabetic would like to know how this
happens, how it can be prevented and what
he or she should know.
Each eye is
like a small camera. The clear front
window lets in light; the clear lens
inside focuses the light; and the delicate
inner lining of the eye (called the
retina) receives the picture like film in
a camera. I any part of the retina is
damaged, it is very likely that some part
of the vision also will be damaged.
Anyone who
develops diabetes early in life or has
adult-onset diabetes long enough will have
retinal damage. The small blood vessels
nourishing the retina weaken and
degenerate. Unfortunately, the central
part of the retina is the most prone to
early damage, and therefore the central
vision is the area most often affected.
The reason for
the damage that occurs in the retina and
progressively weakens the vision is easy
to understand. The blood vessels of the
retina become weak and leak blood, fluid
and cholesterol into the eye. This buildup
in the center of the retina causes blurred
vision. The longer this continues, or the
more serious or uncontrolled the diabetes
is, the more these abnormal blood vessels
begin to leak, grow, and spread. These
new and abnormal blood vessels are
fragile. They rupture easily and bleed
without any apparent reason or warning.
The eye then
fills with blood, and the vision is lost.
Untreated, the blood then forms a scar,
which may become permanent. Later, the
scar will pull on other abnormal vessels,
causing more bleeding, or will pull on the
retina and cause a retinal detachment.
Fortunately,
diabetic patients are living longer
because of more successful medical
treatment. However, the longer a person
lives with diabetes, the greater the risk
of developing the leaking and bleeding,
especially if the diabetes started in
childhood. Other risk factors show that
women are at greater risk, as are African
Americans and older persons.
Since these
changes often occur without symptoms, it
takes a medical doctor to spot these
abnormal vessels by looking into the eye.
Every medical doctor who treats a diabetic
should look into the eyes at least once a
year and refer diabetic patients to an
ophthalmologist is the medical doctor who
specializes in eye problems, eye surgery,
and laser surgery to treat a diabetic's
eye problems.
]The good news
is that almost everyone's vision can be
saved if the problems are found soon
enough and treated. The treatment of
choice is laser light applications to the
abnormal areas of the retina. Laser
treatment of the eye is simple, safe and
very successful. The laser seals the
abnormal blood vessels, spot-welds the
damage, and shrinks scar tissue to prevent
bleeding and detachment. This treatment
can prevent blindness and restore sight.
Because of
these new treatments, diabetics like
Jennifer no longer have to go blind.
Because treatment for diabetic retinopathy
can sometimes only maintain the vision at
its current level, it is absolutely
essential that diabetics have regular
checkups and then have treatment as early
as possible by a specialist if problems
are found.
The evidence
shows that diabetics can help control
their disease and prevent problems by
keeping their blood sugar as normal as
possible, abstaining from smoking and
maintaining a normal weight and blood
pressure. There are 700,000 Floridians
with diabetes, and they are more fortunate
today than ever, since more can be done
now to help preserve their sight. They
should not wait until there is an
emergency; it may be too late! |
