If all individuals with diabetic retinopathy were treated in a timely manner, the incidence of blindness from diabetes could be decreased by 90 percent. Many factors that are completely within your own control have a notable impact on reducing your risk of diabetic retinopathy, including regulating blood sugar and blood pressure, and following recommended checkups.
What Can I Do?
Although some people may not feel they need eye care, most early eye disease has no signs or symptoms. Following recommended exam schedules detects and promotes treatment of diabetic eye disease and cuts the occurrence of severe vision loss by half or more, and early detection and treatment of diabetic retinopathy reduces vision loss by up to 60 percent. Half of adult patients with diabetes do not have annual eye care, however. The most common reasons for skipping eye care given by individuals are that they do not feel they need it or they cannot afford it.
Medicare covers a yearly exam for diabetic neuropathy, and many individuals now have vision coverage through their health insurance. Patients with health insurance are more likely to have recommended eye exams. Lack of insurance increases the probability of eye problems. Uninsured and lowincome individuals are the patients most likely to cite cost as a reason for not seeking care, but even without insurance, dilated eye exams have low upfront costs, reduce patients’ overall costs and increase quality of life.
Who Is Going to Benefit?
Diabetes is on the rise: It currently affects nearly 26 million Americans, or about 8 percent of the U.S. population. The Centers for Disease Control and Prevention recently reported that nearly 2 million individuals were newly diagnosed with diabetes in 2010. Of that group, 30 percent of adults had prediabetes (high blood glucose or glycosylated hemoglobin [A1C] level, but not high enough to be considered diabetic) and half of the elderly population was prediabetic. It is estimated there will be 366 million individuals with diabetes worldwide by 2030.
Diabetic retinopathy is a complication of diabetes and is the leading cause of new-onset blindness in U.S. adults. Because vision decreases slowly with age, many patients do not even realize they have a problem. More than 33,000 new cases of diabetic macular edema and 86,000 cases of proliferative diabetic retinopathy are diagnosed every year in the United States, along with 12,000 to 14,000 new cases of blindness. In addition, within three years after a diagnosis of diabetes, 28 percent of adults will develop diabetic retinopathy and 4 percent will have advanced retinopathy, which can lead to vision loss.
Diabetic retinopathy happens in most patients with Type 1 diabetes and is seen in more than 77 percent of patients with Type 2 diabetes within 20 years after receiving a diagnosis. The longer a person has had diabetes, the higher the chance of retinopathy and blindness. Therefore, the elderly are more affected by diabetic retinopathy, at a rate of 27 percent of individuals older than 65 years.
What Can I Do for Myself?
Treating diabetes can reduce the risk of diabetic retinopathy by 90 percent. The only ways to prevent diabetic retinopathy are by controlling blood sugar, blood pressure and other factors. For example, intensive blood glucose control reduces diabetic retinopathy, even if your A1C level does not improve. In addition, hypertension worsens diabetic retinopathy, as do high cholesterol and high lipid levels. Losing weight, exercising and improving nutrition can significantly improve your health and slow or prevent complications from diabetes. For instance, early use of antioxidants and zinc can reduce visionthreatening age-related macular degeneration by 25 percent.
Adhering to health checks (glucose, blood pressure and cholesterol monitoring; eye and foot exams) recommended by your primary care practitioner can reduce the likelihood of eye problems. Detecting and treating diabetic eye disease can reduce the rate of severe vision loss by half.
What if Self-Care Is not Enough?
- For most (65 percent) patients with diabetes, vision is adequately helped by glasses. If glasses and other self-care are not enough, you can talk to your PCP about the following treatments: Laser photocoagulation more than halves vision loss from diabetic retinopathy, to less than 2 percent.
- Early vitrectomy (removal of the clear gel that fills the eye between the lens and the retina) in patients with Type 1 diabetes may reduce the amount of time they have poor vision after diabetic vitreous hemorrhage (bleeding). Early vitrectomy showed no advantage for Type 2 diabetes.
http://health.usnews.com/health-news/patient-advice/articles/2016-04-12/eye-health-insights-for-patients-with-diabetes
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