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VISANTE OPTICAL COHERENCE TOMOGRAPHY

Dr. Edward Boshnick
8479 Coral Way
Miami, FL 33155
(305) 264-4400
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Diabetes and the Eye

Diabetes is a disease that affects the body's ability to produce or respond to insulin (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, which usually occurs during childhood or adolescence and type 2, the most common form of the disease which usually occurs after age 45.

Diabetes is the fifth deadliest disease in the United States and it has no cure. Diabetes is the #1 cause of blindness in the United States.

The major cause of blindness in people with diabetes is diabetic retinopathy. Diabetic retinopathy is a term used for all abnormalities of the small blood vessels of the retina caused by diabetes. The walls of these blood vessels weaken causing blood to leak. Retinopathy progresses from non-proliferative or background retinopathy to proliferative retinopathy.

Non-proliferative retinopathy is a common, usually mild form that generally does not interfere with vision. Abnormalities are limited to the retina and usually will only interfere with vision if it involves the macula, the area of the retina that gives us the sharpest vision. If left untreated, it can progress to proliferative retinopathy.

Proliferative retinopathy, the more serious form, occurs when new blood vessels branch out or proliferate in and around the retina. It can cause bleeding into the fluid-filled center of the eye or swelling of the retina, and lead to blindness.

The following are important facts to know about this devastating disease:

Nearly all patients who have type 1 diabetes for about 20 years will have evidence of diabetic retinopathy.
Up to 21% of people with type 2 diabetes have retinopathy when they are first diagnosed with diabetes, and most will eventually develop some degree of retinopathy.
In the United States, diabetes is responsible for 8% of legal blindness making it the leading cause of new cases of blindness in adults 20-74 years of age. Each year between 12,000 to 24,000 people lose their vision because of diabetes.
Glaucoma, cataract and corneal disease are more common in people with diabetes and contribute to the high rate of blindness.
Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Smoking increases blood pressure and raises one's blood sugar level which makes it harder to control diabetes.

The key to preventing diabetes related eye problems is good control of blood glucose levels, a healthy diet and good eye care. Studies have proved that patients with improved blood glucose control have a much smaller risk of developing diabetic retinopathy (a 76% lower risk).

Because a person with diabetes can have diabetic retinopathy and not know it, regular eye evaluations by an eyecare professional is essential. Dilated eye exams should be performed annually. Women with type 1 diabetes who are pregnant should have a comprehensive eye exam in the first trimester and close follow-up visits throughout pregnancy.