January 4, 2014

Many Patients Claim, Not Informed About Vision Loss

This in one topic that will part of our January meeting, weather permitting. I was very skeptical when I first read this article. I can only say that I am very fortunate that I have had this explained to me by my primary care doctor and my eye doctor several times. Even my endocrinologist brings this up once a year to check that I have kept my eye exam appointment. I even become annoyed by how often I am reminded to have my eyes checked. Since vision is so important, I am very shocked that people don't remember they were told to have a yearly eye exam.

According to the reported study, less than half of the adults who are losing their vision to diabetes have been informed by a doctor that diabetes could damage their eyesight. Vision loss is a complication of diabetes named retinopathy. The vision loss is caused by damage done to the small blood vessels within the eye.

Johns Hopkins researchers found that many diabetics aren't taking care of their eyes. They are not even aware that vision loss is a potential problem. Nearly three of every five adults with diabetes in danger of losing their sight told the researchers they couldn't recall a doctor describing the link to diabetes and vision loss. The study appeared in December 19 online issue of the journal JAMA Ophthalmology.

Study leader Dr. Neil Bressler, a professor of ophthalmology at the Johns Hopkins University School of Medicine, and chief of the retina division at the Johns Hopkins Wilmer Eye Institute, says that many of the participants were not seeing an eye doctor for eye problems. Two in five hadn't received a full eye exam with dilated pupils.

Dr. Bressler said that this is a shame because in many of these cases you can treat this condition if you catch it in an early enough stage. With one-third of the people already experiencing some vision loss related to their diabetes, Dr. Bressler said vision damage can be prevented or halted in about 90 to 95 percent of cases, if doctors see the patients early enough.

Dr. Ratner of the ADA called the finding frightening and depressing. He says, “This paper is an excellent example of where the American health care delivery system has fallen down in an area where we can do better.” He then continues as only Dr. Ratner could by saying, “Doctors need to enforce standards of care and that type 2 people with diabetes ought to receive full examinations with pupil dilation every two years.” The ADA standards of care say these patients should be promptly referred to an eye specialist. He finished by saying. "We will continue to push for health care professionals to meet the minimum standards of care."

Again, I would disagree with Dr. Ratner, because I am being told by my eye doctor to have an appointment every year, and this is the same as my endocrinologist keeps telling me. The study did most of the study on people with type 2 diabetes who had "diabetic macular edema." This condition occurs when high blood sugar levels associated with poorly controlled diabetes cause damage to the small blood vessels in the retina, the light-sensitive tissue lining the back wall of the eye.

As the vessels leak or shrink, they can cause swelling in the macula, a spot near the retina's center that is responsible for your central vision. Macular edema can ruin your ability to see detailed images and objects directly in front of you, and ultimately can lead to permanent vision loss. Recent reports estimate that the eye disease affects about 745,000 people with type 2 diabetes in the United States.

For more information on diabetes and vision problems, visit the U.S. National Eye Institute at theirwebsite.

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