Diabetic Eye Disease

Eye Care about My ABCs

A Healthy Eyes Healthy People Project Sponsored in part by the AOA and VSP

The ABCs of Diabetes

A1C-test measures average blood glucose levels over the last 3 months, high levels can lead to diabetes problems.

Blood Pressure -high blood pressure causes heart disease and damages your blood vessels, raising your chances for eye problems

Cholesterol-bad cholesterol, or LDL, builds up and clogs your arteries

Target levels for ABCs…

A1C-for most people with diabetes is less than 7

Blood Pressure -Below 130/80mmHg Cholesterol (LDL)-less than 100 for people

with diabetes

*personal glucose levels should range between 80-120 before meals and 100-140 at bedtime

Diabetes is Serious!

In the US, Diabetes is: #1 Cause of BLINDNESS #1 Cause of AMPUTATION #1 Cause of KIDNEY FAILURE TWICE as many HEART ATTACKS THREE times as many STROKES #3 Cause of DEATH

Who gets Diabetes?

20.8 million people in the United States– 7% of the population– 1/3 don’t even know they have the disease

Diabetes is more common among:– African-Americans– Hispanics

When does Diabetes arise?

Types of diabetes: Type I- begins before the age of 20

– 10% of Americans with diabetes

Type II- begins in middle age– Most common– Recently developing in children

Gestational- during pregnancy

What is Diabetes?

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

If you are a person with diabetes some of the food you eat does not make it to your muscles, brain, etc. and stays in your blood.

How does insulin work?

Insulin is the Key that allows sugar in to the cells of the body.

Glucose / “Blood Sugar” The Cell

Insulin

Type I Diabetes

The Cell

Glucose

With out Insulin, glucose cannot enter the cell

Type II Diabetes

Insulin

The CellGlucose

Insulin does not work properly. The Key does not Fit!

Where does diabetes affect the body?

If sugar from the food you eat can’t get to your muscles and organs, where does it go?

Sugar builds up in your blood and causes damage to your blood vessels.

The first blood vessels affected are the smallest.– Finger and Toes– Kidneys– Eyes

Why do people get diabetes?

The direct cause of diabetes is unknown– Genetics– Environmental factors

Diet and obesityLack of exercise

Who gets Diabetic Eye Disease,When do they get it, and Why?

People with diabetes who do not control their blood sugar or who have shown decent control but have been diabetic for many years.

What is Diabetic Eye Disease?

The effects of Diabetes on the eye. Diabetic Retinopathy is the leading cause of

blindness among adults in the US. Over 112,000 people in Indiana alone have

diabetic retinopathy. That’s ~20% of all persons with diabetes.

In Indiana, ~60% of people with diabetes receive an annual eye exam.

Where does it affect the eye?

Lens: variations in blood sugar can cause variations in the power of the lens. Uncontrolled diabetics are prone to intermittent blurry vision.

Retina: Diabetic Retinopathy is when the eye’s blood vessels become leaky and can ultimately bleed profusely.

Retina

Where does it affect the eye?

Lens: variations in blood sugar can cause variations in the power of the lens. Uncontrolled Diabetics are prone to intermittent blurry vision.

Retina: Diabetic Retinopathy is when the eye’s blood vessels become leaky and can ultimately bleed profusely.

Mild Diabetic Retinopathy

Leaky blood vessels are a warning sign that serious problems may arise.

This is the time to take control of your blood sugar before it is too late.

Serious Diabetic Retinopathy

If leaky blood vessels go unnoticed and untreated, they can ultimately bleed.

Bleeding means Blindness!

How is serious diabetic retinopathy treated?

If bleeding has occurred, lasers can be used to attempt to stop the bleeding.

Laser surgery does not usually improve vision, it tries to stop vision from worsening.

Vision Loss from Diabetic Retinopathy

Normal or Mild Diabetic Retinopathy

Severe Diabetic Retinopathy

Additional effects on the eyes

In addition to the damaging effects of diabetes on the eye, diabetic eye disease also increases the risk for developing:– Cataracts-

A clouding of the natural lens of the eye– Glaucoma-

High eye pressure associated with nerve damage

How do I avoid getting Diabetic Eye Disease?

ABCs– A1c, Blood sugar, Cholesterol– Diet and exercise

Annual dilated eye exams!– Diabetics with excellent control of blood sugar.

Uncontrolled diabetics…– Diabetics who have fluctuating blood sugar or

who have shown signs of diabetic retinopathy may require more frequent exams.

Why so many exams? Why do I have to be dilated?

What the doctor sees…

Undilated pupil Same Eye-- pupil dilated

How to find an Optometrist

Medicare beneficiaries can receive assistance getting an eye exam via their:

“Diabetes Hotline” 800-826-3947 Eye Care Community Outreach (ECCO)

– Helping Hoosiers find and afford eye care. – Dewana-317-321-1413; Kelli-317-321-1424

Indiana Optometric Association– 317-237-3560

American Optometric Association– www.aoa.org “Doctor Locator”

Questions???

POP QUIZ!!!

QUIZ #1 True or False

People with diabetes are more likely than people without diabetes to develop certain eye diseases.

True. Diabetic eye disease includes diabetic retinopathy—a leading cause of blindness in adults—cataract, and glaucoma. The longer someone has diabetes, the more likely he or she will develop diabetic eye disease.

#2 True or False

Diabetic eye disease usually has early warning signs.

False. Often there are none in the early stages of the disease. Vision may not change until the disease becomes severe.

#3 True or False

People with diabetes should have yearly eye examinations.

True. Everyone with diabetes should get an eye examination through dilated pupils at least once a year. Because diabetic eye disease usually has no symptoms, regular eye exams are important for early detection and timely treatment.

#4 True or False

Diabetic retinopathy is caused by changes in the blood vessels in the eye.

True. In some people, blood vessels in the retina may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina.

#5 True or False

People with diabetes are at low risk for developing glaucoma.

False. Glaucoma is almost twice as likely to occur in people with diabetes than in those without the disease. Glaucoma can usually be treated with medications or laser or other surgery.

#6 True or False

Laser surgery can be used to halt the progression of diabetic retinopathy.

True. In laser surgery, a special beam of light is used to shrink the abnormal blood vessels or seal leaking blood vessels. Laser surgery has been proved to reduce the five-year risk of vision loss from advanced diabetic retinopathy by more than 90 percent.

#7 True or False

People with diabetes should have regular eye examinations through dilated pupils.

True. An eye examination through dilated pupils is the best way to detect diabetic eye disease, in which drops are used to enlarge the pupils. This allows the eye care professional to see more of the inside of the eye to check for signs of the disease.

#8 True or False

Cataracts are common among people with diabetes.

True. People with diabetes are twice as likely to develop cataracts and to develop them at an earlier age than are those without diabetes. Cataracts can usually be treated with surgery.

#9 True or False

People who have good control of their diabetes are not at high risk for diabetic eye disease.

False. Even with good control of blood glucose, there is still a risk of developing diabetic eye disease. However, studies show that careful management of blood sugar levels slows the onset and progression of diabetic retinopathy.

#10-- True or False

The risk of blindness from diabetic eye disease can be reduced.

True. With early detection and timely treatment, the risk of blindness from diabetic eye disease can be reduced.