MEDICAL SURFARI: INSIGHT TO EYESIGHT FOR DIABETICS

When most people think of diabetes they think of a disease wherein the body has difficulty maintaining the proper level of blood sugar because of the absence or ineffectiveness of circulating insulin. They may even know that it is a serious disease that can cause problems including heart disease, kidney disease and other circulatory problems that may even at times result in amputations.

Many people are unaware that diabetes causes a variety of eye problems that may go undetected without a proper dilated eye examination. Although most people who have diabetes have only minor eye problems, this disease can cause other very serious problems that may result in severe loss of vision or even blindness.

People with diabetes are almost twice as likely to develop glaucoma, which is a condition wherein the pressure inside the eye becomes elevated. This increase in pressure damages the sensitive structures within the eye that communicate the image received in the eye to the brain. This condition has been referred to as the "sneak thief of sight" because patients with this condition may have no signs or symptoms of the disease. The condition is diagnosed by having the intraocular pressure (IOP) measured. This can be done by your optometrist, ophthalmologist or even at glaucoma screenings that are often provided through the local Lions Clubs. Glaucoma is often easily treatable with medicated eye drops although some forms require laser or surgical treatment.

Patients with diabetes are also at risk for developing cataracts that result in clouding of the lens within the eye. Studies show that people with diabetes are twice as likely to develop a cataract and are more likely to develop it at an earlier age than those without diabetes. Most cataracts can be effectively treated with surgery.

A third type of diabetic eye disease called diabetic retinopathy is the leading cause of blindness in American adults. In the back of each eye there is a thin layer of tissue called the retina that receives the images projected by the lens of the eye. This sensitive layer records the image that is seen and transmits it through a complex system of nerves to the optic nerve, which in turn transmits the image to the brain where it is interpreted. The retina is a highly vascular layer and some of these retinal blood vessels may swell and leak fluid, which may distort or damage the retina resulting in vision loss or blindness. This condition may also progress a long way without any symptoms. Nearly half of all people with diabetes will develop some degree of diabetic retinopathy during their lifetime. November is National Diabetes Month and this is a time when many organizations including Prevent Blindness America and the National Eye Institute as well as 21 other organizations are working together to raise community awareness of the various forms of diabetic eye disease.

If you have diabetes, the key to preventing vision loss is taking good care of yourself by getting regular exercise, maintaining a healthy diet and keeping your blood sugar under good control. Beyond these basics, early detection of diabetic eye disease is essential in preventing vision loss.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63702-0699.