Great info

Keeping an eye on vision maladies for diabetics By Rosemary Boggs

No one ever injured his eyesight by looking on the bright side of things. - Anonymous

Over the last few years I've noticed my eyesight getting worse. Of course working on a computer for eight hours a day doesn't help, and we won't even go into the amount of TV I watch some days. I had started noticing that my sight was clear close up, but distant things, even across the newsroom, were blurry. Especially after a long day's work. But being diabetic means I need to take special care of my eyes. And that means I should have a yearly dilated eye exam. My doctor had been stressing that I needed a diabetic eye exam, but as is my way, I put it off and put it off and put it off. Then late last year I gave in and went. It was an eye-opening experience! I now have a nice pair of glasses that I use for watching TV and driving. And the good news: There are no signs of diabetic eye problems. I decided to dig a little deeper into this topic and ran across practical information on the website of the National Eye Institute (nei.nih.gov/ health). Here's the gist of it: People with diabetes are more likely than people without diabetes to develop eye diseases that include cataracts, glaucoma and diabetic retinopathy, which is a leading cause of blindness in adults. The longer you are diabetic the more likely you will develop eye disease. The retina is the light-sensitive tissue lining the back of the eye. It converts light into electrical impulses that are sent to the brain through the optic nerve. A healthy retina is necessary for good vision. Diabetic retinopathy is caused by changes in the blood vessels in the eye. In some people, blood vessels in the retina can swell and leak fluid. In others, abnormal new blood vessels grow on the retina's surface. There are often no signs in the early stages of the disease. Vision might not change until the disease becomes severe. Laser surgery can be used to halt the progression of diabetic retinopathy. A special beam of light is used to shrink the abnormal blood vessels or seal leaking vessels. This procedure has been proved to reduce the five-year risk of vision loss from advanced diabetic retinopathy by more than 90 percent. Diabetics are twice as likely to develop cataracts, too, and they often develop at an earlier age. But they can usually be treated with surgery. And even with good glucose control, there is still a risk for developing diabetic eye disease. Careful management of blood sugar levels can slow the onset and progression of diabetic retinopathy. The American Diabetes Association (diabetes.org) also offers good information. They note the importance of keeping blood sugar levels under control. High levels can make your vision temporarily blurry. High blood pressure can make eye problems worse, so bringing blood pressure under control is important too. The association recommends that smokers quit. Smoking damages many organs, including the eyes. And that includes first- and secondhand smoke. Other reasons for concern might include: Difficulty with color perception; Trouble reading books orsigns; One or both eyes hurt; Spots or floaters; Straight lines that do not look straight; Seeing double, or just not as well as we used to. ASK AN EXPERT Next I reached out to Dr. Sami Uwaydat with some specific questions. Uwaydat is the director of the Retina Service at the University of Arkansas for Medical Sciences Harvey & Bernice Jones Eye Institute, and an assistant professor in the department of ophthalmology in the UAMS College of Medicine. Uwaydat says that diabetes affects many parts of the eye. The cornea becomes more prone to develop abrasions, cataracts develop earlier, and, as was already mentioned, blood vessels in the retina can leak and/or bleed, causing a loss of vision. Also, diabetes can affect the nerves that control eye movement. Uwaydat says a complete diabetic eye exam should evaluate vision, movement of the eye and intraocular pressure, which means within the eye. IN THE EXAM ROOM I'd never had my eyes dilated, so it was a bit of an experience. The assistant put in drops, and after I sat for a few minutes in a darkened room, a nice gal took close-up photos of my eye from eight to 10 angles. A computer then combined all the shots into one, for a view of the whole eye. Seeing your whole eyeball like that is just downright neat. And dilating the pupil, Uwaydat says, enables the doctor to examine the structures at the back of the eye, mainly the retina. Other tests might include: Color photos of the retina; Fluorescein angiography, in which dye is injected in the patient's vein and then pictures are taken of the back of the eye to assess blood circulation in the retina; Optical coherence tomography, which is a special scan that determines if the retinal vessels are leaking fluid into the retina. Uwaydat recommends that patients have someone drive them home after a fully dilated eye exam. I went for my exam after work and drove myself home. I had nice dark sunglasses and managed to make it home OK, but it's amazing how bright and shiny everything looked for a few hours. OLD WIVES' TALES So, I wondered, can exercise be beneficial to the eyes? Uwaydat says that exercise improves the control of diabetes. Patients who control their diabetes and improve blood sugar levels are less prone to develop the ocular complications of diabetes. As for the old you'll go blind if you watch TV too close statement I remember hearing from my mother, and reading in dim lighting: Uwaydat assured me that we will not go blind by doing either. On the other hand, for children, doing too much activity that requires focusing near to the face may increase the chance of becoming nearsighted. The main thing for diabetics is to get regular eye exams whether we have symptoms or not. And a finding of normal vision doesn't mean that diabetes hasn't affected the retina, either. Treatments are available to manage the complications of diabetic retinopathy, and they work best before the patient loses vision.