Linda Conlin, Pro to Pro Managing Editor
Is it coincidence that as soon as we’ve finished the left over Halloween candy, comes November and National Diabetic Eye Disease Month? Coincidence or not, Prevent Blindness takes diabetic eye disease very seriously with more than 29 million American diabetics and their increased risk of several sight threatening diseases. Diabetic eye disease is not just one, but a group of eye conditions that affects people with diabetes. Those conditions include diabetic retinopathy, diabetic macular edema (DME) cataract and glaucoma.
Diabetic retinopathy occurs when high blood glucose levels damage retinal blood vessels, causing them to leak or close, or abnormal new blood vessels grow in the retina, all threatening sight. Diabetic macular edema occurs when retinal blood vessels leak causing fluid to accumulate in the macula. This results in a decrease in central vision. What’s more, diabetics are at four times the risk as the general population for posterior subcapsular cataract, which forms at the back of the crystalline lens, beneath the lens capsule.
Glaucoma is not elevated intraocular pressure in and of itself; it is the damage to the optic nerve as a result of that pressure. Someone can have elevated intraocular pressure, but if there is no optic nerve damage, that person is not considered to have glaucoma. How does diabetes play a part in glaucoma? Studies have found that people with Type 1 (juvenile onset) diabetes and elevated blood glucose levels also have higher levels of glutamates. Glutamates are important neurotransmitters, but in excess can kill cells. Excess glutamate levels are a major cause of the loss of retinal ganglion cells.
These conditions come with not only a risk to precious sight, but at a cost. Prevent Blindness America’s 2007 Economic Impact of Vision Problems report notes that 420,697 diabetics age 65 and older were using outpatient medical services for vision problems at a cost of $490 million. Considering an average annual inflation rate of 1.7% since then, that cost is now approximately $833 million if the number of diabetics in that age range remained the same. It has not. The NIH predicts that by 2050, the number of diabetics in that age group will soar to 26.7 million. I won’t do the math, but clearly, the cost will be staggering.
Prevention and early detection are the keys to saving sight for diabetics. A healthy lifestyle and physician monitoring, especially for those at risk for Type 2 (adult onset) diabetes is critical. Equally important are regular eye exams with dilation and/or retinal photos. A close look at the back of the eye often detects diabetes before the patient has other symptoms. As ECPs, we must help raise patient awareness of the risks to vision and the value of a comprehensive eye exam.
Did you know contact lenses that can monitor blood glucose levels are under development? Imagine the health benefit of constant glucose monitoring without a finger prick! You can learn about them with our CE Therapeutic Contact Lenses and Beyond at www.2020mag.com/ce.