Individuals with diabetes are likely accustomed to regular insulin injections or a strict diet. But are they as familiar with regular eye examinations? According to the results of a 2013 survey coinciding with National Diabetes Month, the majority of diabetic patients would say no, even though diabetes is a leading cause of vision loss in the US.
According to the National Eye Institute (NEI) of the National Institutes of Health (NIH), around 25 million Americans suffer from diabetes.
The Centers for Disease Control and Prevention (resource no longer available at www.cdc.gov) (CDC) states that diabetes is the leading cause of blindness among adults aged between 20 and 74.
Figures from the CDC show that between 2005 and 2008, 4.2 million diabetes patients in the US had diabetic retinopathy - the most common form of diabetic eye disease. Of these, 655,000 suffered from advanced diabetic retinopathy, which can potentially lead to severe vision loss.
However, a new survey from Diabetic Connect - the largest social networking site for diabetes sufferers and their families - reveals that 25% of people with diabetes do not have the recommended annual dilated (retina) eye exam, which experts say could significantly reduce the risk of vision loss or blindness associated with diabetes.
Diabetic eye disease explained
Diabetic eye disease is defined as a group of eye-related health issues that are particularly common among diabetes sufferers.
The NEI says the risk of severe vision loss from diabetic retinopathy could be reduced by 95% with early detection, timely treatment and appropriate follow-up.
Diabetic retinopathy is the leading cause of blindness in diabetics - caused by a change in the blood vessels situated in the retina.
Some people with this disease experience swelling and fluid leaking from the blood vessels into the macula of the eye - the part of the retina that is responsible for sharp vision. This process is known as diabetic macular edema (DME).
Other people with diabetic retinopathy will have new blood vessels form on the surface of the retina. Both of these changes can lead to partial vision loss or complete blindness.
One major problem for patients with diabetic eye disease is that there are often no symptoms until the disease reaches an advanced stage. However, it can be detected early through a dilated eye exam.
"The best way to prevent unnecessary vision loss is through annual retina eye exams," Dr. Carl C. Awh, retina specialist at Tennessee Retina, a group of nationally recognized specialists, told Medical News Today.
"Very often diabetic eye disease lacks any symptoms - meaning people may not know that their vision has been damaged until it's too late."
According to the NEI, with early detection through a dilated eye exam, timely treatment and appropriate follow-up, the risk of severe vision loss from diabetic retinopathy can be reduced by 95%.
Through early detection of diabetic retinopathy and other eye diseases, several treatment options can be offered to a patient.
These include laser eye surgery and injections of anti-vascular endothelial growth factor (anti-VEGF) medications. These block the actions of a protein that is the cause of abnormal blood vessel growth and leakage in the eye.
Below is a video from the NEI that explains the risk and treatment of diabetic eye disease:
Majority of diabetics 'unaware of risk' to eye health
Although people with diabetes are encouraged to have a dilated retina eye exam once every year, it seems many diabetes sufferers do not undergo these regular eye check-ups.
Diabetic Connect conducted an online survey of 1,674 patients with either type 1 or type 2 diabetes. The survey revealed that 1 in 4 people do not receive their annual eye exam, and the reasons for this are largely down to lack of awareness.
In detail, only 36% of people with diabetes said they had spoken with their doctor regarding their risk of vision loss when they were diagnosed, and 22% had never spoken to their doctor about this topic.
Of those who have never had a retina eye exam, 13% said it was because they believed they had not had diabetes long enough for it to affect their vision.
Over 50% of respondents were unaware that diabetic macular edema was a leading cause of vision loss or blindness for diabetes sufferers, and 32% did not know they needed a dilated eye exam.
Needless to say, the results of this survey are worrying, especially considering the millions of diabetes sufferers who are at risk of eye disease.
Dr. Awh said there is no doubt that there needs to be more awareness among diabetic patients regarding potential vision loss and the need for regular testing.
"In part it comes from the primary care doctors and nurses. Broader public awareness and education is also needed," he added.
One diabetes sufferer told Medical News Today that if it was not for her awareness of the risk of diabetic eye disease, the quick actions of her endocrinologist and regular eye tests, she may have lost all vision.
'If it wasn't for regular eye exams, I would have gone blind'
Suzanne Gardner was diagnosed with type 1 diabetes at the age of 7.
In 1999, Suzanne began experiencing problems with her vision, such as seeing blurred colors and the inability to see details. She said she was previously made aware of the risk of vision loss due to her diabetes.
"In fact, vision loss was something that was of great concern to people who had diabetes," she added.
"However, 41 years ago, the technology for diabetes was not as advanced as it is today. We had no means of testing blood glucose at home. So diabetes couldn't be as well controlled as it is today with home glucose monitoring machines and insulin pumps."
Suzanne visited an ophthalmologist who diagnosed her with diabetic retinopathy. Within 2 years of diagnosis, Suzanne was deemed legally blind.
"Despite a series of operations, my doctors could only save partial vision in one of my eyes," she said.
However, despite this devastating outcome, Suzanne says that if it was not for regular eye examinations, she may have lost all vision:
"As soon as my endocrinologist saw signs of diabetic eye disease, we all took it very seriously.
She sent me to see a specialist who deals specifically with the retina. If it had not been for the constant visits and immediate attention of my retina specialist, I would have gone completely blind."
'It's important for people to know about vision loss risk'
In spite of her vision loss, Suzanne has made a successful career for herself in the form of art.
"I was devastated by my vision loss. I couldn't work and couldn't drive. All of a sudden, everything about how I defined myself had changed," she told Medical News Today.
"When a friend suggested I start painting, it was the last thing on my mind. But when I picked up the brush, it helped me through a very dark time in my life after my diagnosis, and I decided that I wanted to begin creating artwork for a living."
Soon after the discovery of her love of art, she became a professional artist and was selling her artwork online and at shows.
"My limited eyesight gave me a new appreciation for vivid colors and focused my work on what I could accomplish, despite vision loss," she said.
"I have learned to rely on my memory and use strong magnifying glasses since it is difficult for me to see details. I also use bright contrasting colors, which are easier for me to distinguish."
Not only is Suzanne's success as an artist a personal achievement, but she also hopes her work inspires other diabetes sufferers to look after their vision.
"It's important for people to know about the risk of vision loss from diabetes. It's my mission to use art as a way to remind people that their sight is worth protecting.
Because of my experience, it's important to me that my paintings make a statement. I hope people see my art, hear my story and are inspired to prioritize their vision."
Reducing the risk of diabetic eye disease
There is no doubt that by having annual retina eye exams, the risk of vision loss as a result of diabetes could be significantly reduced. But what does a dilated examination involve?
During the test, eye drops are put into a patient's eye. These drops cause the pupils to open, allowing the doctor to clearly assess all structures of the eye, including the retina, to determine whether there is any damage or early signs of disease.
"Ophthalmologists, optometrists and retina specialists are able to conduct these exams and can direct patients to the appropriate specialists if there are findings," explained Dr. Awh.
As well as regular dilated eye exams, the NEI says that diabetes sufferers can also reduce their risk of diabetic eye disease though good control of blood sugar, blood pressure and cholesterol levels.
To find information about how diabetes can cause vision loss, the retina eye exam and to find a retina specialist in your area, you can visit Diabetes Eye Check, a part of the American Society of Retina Specialists (ASRS).