Diabetes is now one of the leading causes of vision loss and blindness in the United States. Unfortunately diabetes is reaching epidemic levels in this country with as many as twenty-six million Americans presently suffering with this disease and a quarter of these people don’t even know that they are diabetic. Even more disturbing is the fact that there are seventy-nine million Americans with higher than what is considered normal blood sugars that haven’t yet developed the disease. There are many reasons for this problem not the least of which is that while we may very well be the richest nation we are also the most obese. Dr. Albright at the Center of Disease Control and Prevention has estimated that by 2050 one in three adults may suffer from diabetes with ethnic minorities having a ratio as high as one in two. Presently diabetes is the leading cause of new cases of blindness with national health care costs as high as $500 million dollars a year.
Blood tests are important in diagnosing diabetes before symptoms occur. Fasting blood sugars below 100 are considered normal with levels below 125 considered prediabetes. Hemoglobin A1C levels are another excellent way of determining whether one has diabetes. It can measure the amount of blood glucose bound to red blood cells over a 3 month period. Values less than 6% are considered normal. While blood tests such as fasting blood sugars and hemoglobin A1C tests are the best screening tests for diabetes only a thorough eye exam can tell you if you have diabetic involvement of your eyes. Early detection is important to prevent vision loss and blindness that is often not reversible. High blood sugar levels which occurs in diabetes is associated with higher rates of cardiovascular disease, kidney disease and eye disease. Since the earliest signs of diabetes usually occur in the retina the Doctors at North Shore Eye Care recommend that you have a dilated retinal exam. By dilating the pupils of your eye we are able to visualize your entire retina. If it appears normal no further work-up is required. Good control of your blood sugars are important however to prevent future disease. Monitoring blood pressure and kidney function are equally important. Since diabetes can still cause damage to your eyes even with good control annual exams are advised.
Luckily newer diagnostic and treatment modalities have been developed which have resulted in a decline in vision loss recently. Fluorescein angiography can detect swelling in the retina and drop out of the smallest vessels in the retina known as capillaries. This is important since capillary dropout means retinal tissue vital for vision is not being perfused so that oxygen is not able to reach these affected areas. To compensate abnormal vessel formation known as neovascularization occurs that can lead to hemorrhages and retinal detachments that may not be treatable. In addition to fluorescein angiography the doctors at North Eye Care also utilize optical coherent tomography (OCT) which enables us to visualize the retina with microscopic detail. Keeping pace with improved diagnostics, new treatment modalities such as the use of vascular endothelial growth factor inhibitors have proved invaluable in preserving vision. In addition to these VEGF inhibitors, intraocular steroids and laser photocoagulation have been shown to be quite effective. As mentioned above all diabetics require early screening to detect early signs of diabetic damage to your eyes before vision is lost. For your convenience we have offices located conveniently throughout Nassau and Suffolk counties of Long Island