Preventing vision loss in diabetics

Diabetes is one of the most prevalent diseases today. In 1995, it was estimated that there were 135 million adult diabetics in the world and it is forecast that in 2025, the number will increase to 300 million. The means that the number of diabetics will be more than doubled in 25 years.

Although there are no local statistics readily available, a 1996 study by the Philippine Diabetes Association reveals that the blood sugar level among Filipinos increases after the age of 40.

Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Insulin is the hormone that regulates the level of sugar (glucose) in the blood.

There are two types of diabetes, namely, type 1 or juvenile diabetes and type 2 or sometimes called adult-onset diabetes.

Many factors contribute to the high prevalence of type 2 diabetes: aging population, imbalanced diet, increased sugar consumption, and poor blood sugar control.

Diabetes gives birth to many complications such as diseases affecting the heart, kidney, the nerves and even the eyes. The most common eye complication is called diabetic retinopathy.

Diabetic retinopathy occurs when the tiny blood vessels in the retina, the light sensitive tissue at the back of the eye, become damaged. A healthy retina is necessary for good vision.

The disease is the principal cause of blindness in industrialized countries. As many as 50 million people worldwide are affected with some form of diabetic retinopathy, 2.5 million of whom are already blind.

The symptoms of diabetic retinopathy vary depending on the stage of the disease but the most common are blurred vision, floaters, flashes and sudden loss of vision.

Blindness may occur in two ways. First, fragile, abnormal blood vessels may develop and leak blood into the center, thus affecting vision. Second, fluid may leak into the center of the macula, the part of the eye where sharp vision occurs. The fluid causes swelling of the macula, resulting in blurred vision.

Unfortunately for diabetics, the disease often has no early warning signs. Reduced visual acuity occurs during the advanced stage of the disease and it usually affects both eyes.

A study carried out in the United States and five European countries showed that out of 3,000 diabetic patients questioned, 60 percent were not worried about loss of vision. This is an alarming percentage because around 74 percent of diabetics are afflicted by an eye disease, sometimes without the patients being aware of it.

Furthermore, the management of patients who have diabetic retinopathy can be expensive with costs that go as high as $500 million a year in the US.

Thus, it is a must for all diabetics to have a complete eye exam or CAEE by a general ophthalmologist at least once a year. This may include the visual acuity test, the dilated eye exam (where drops are placed in the eye for retina examination) and the internal eye exam using an ophthalmoscopy.

If the eye exam results show that the patient has diabetic retinopathy, he is then referred to a retina specialist. The retina specialist will recommend the treatment to arrest the progression of the disease. Treatment of the disease may include medicines, laser surgery or conventional surgery.

The patient will also be required to learn to control his blood sugar level, blood pressure and blood cholesterol. Timely treatment and follow-up care will help in the management of diabetic retinopathy and prevent vision loss, thus giving diabetics a chance to lead happy, normal lives.