Michigan Chronicle
10-04-2005
It takes more than covering one eye, and then the other, to make sure your
eye-sight is good--especially for people with diabetes, according to Dr.
Donald G. Puro, an ophthalmologist at the University of Michigan's Kellogg
Eye Center in Ann Arbor.
'It's important for people to see their general medical doctor to be
screened for diabetes,' said Puro, who is also a member of the American
Diabetes Association. 'Too many people have diabetes and don't know it. If
they have diabetes, then they need to see an ophthalmologist, yearly, for
early changes that can occur with their vision.'
Diabetes is responsible for eight percent of legal blindness in the United
States. Each year, 12,000 to 24,000 people in this country lose their site
due to diabetes. The disease is the leading cause of new cases of blindness
in adults ages 20 to 74. Glaucoma, cataract and corneal disease are more
common in people with diabetes and contribute to the high rate of
blindness.
Nearly all patients who have Type 1 diabetes for about 20 years will have
evidence of diabetic retinopathy. And up to 21 percent of people with Type
2 diabetes have retinopathy when they are first diagnosed with diabetes.
Diabetic retinopathy--the major cause of blindness in people with
diabetes--is a term used for all the abnormalities of the small blood
vessels of the retina caused by diabetes, such as weakening of blood vessel
walls or leakage from blood vessels.
Retinopathy has two forms: non-proliferative retinopathy and proliferative
retinopathy. Non-proliferative retinopathy is common and usually mild, and
does not generally interfere with vision, unless abnormalities involve the
macula--the area on the retina that gives the sharpest vision. If left
untreated, it can progress to the more serious proliferative retinopathy
where new blood vessels branch out around the retina and can cause bleeding
in the fluid-filled center of the eye or swelling of the retina.
'Hemorrhaging can occur,' Puro said. 'The blood vessels also can incite
something like a scarring reaction in the eye and can pull the retina out
of place. That can lead to a complete loss of vision.
'The outside of the eye may look completely normal, but the stage could be
set for something to happen and the person wouldn't know it. You have to
dilate the pupil and look through the pupil to see the retina to see the
problem.'
The key to preventing diabetes-related eye problems is good control of
blood glucose levels, a healthy diet and good eye care, Puro added.
'Excellent control of blood sugar levels has been shown to slow down
diabetic retinopathy,' he said. 'Studies have proven that. The test is
hemoglobin A1C, which shows how good the control of diabetes has been for
the past three months. Below seven is the goal. But some people can have
levels of 11, 12 or 13 and that's very high risk.'
According to the American Diabetes Association, early detection is
important to reduce cases of blindness due to diabetes. Patient education,
health care team education and affordable eye care can make this possible,
but sometimes that is difficult in the African American community, Puro
said.
African Americans are twice as likely to suffer from diabetes-related
blindness as non-Hispanic whites.
'Many African Americans aren't plugged into the system as well as we would
like,' he said. 'Maybe they don't have health insurance or there are other
socioeconomic issues that prevent them from getting the yearly check of
things.'
Article copyright Michigan Chronicle Publishing Company, Inc.
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