Good Vision Should Be A National Priority

Diabetes affect on vision often detected too late

By A.Paul Chous, MA, OD, FAAO

April is National Save Your Vision Month, a media campaign designed to educate the public about good vision, good eye health, and ways to achieve and maintain both of these. Most people with diabetes have heard that it can lead to reduced vision or blindness but, amazingly, almost 50% of people with diabetes do not get regular dilated eye exams (perhaps because they don't realize that diabetic eye disease may not affect one's eyesight until it is "too late" to reverse serious damage).

 

For most people, including those of us with diabetes, vision is perhaps our most precious sense. Yet, good eye sight and eye health are not automatic, and usually receive only a fraction of the attention paid to dental hygiene and health, for instance. This is very unfortunate, because vision loss from eye disease and other vision disorders is largely preventable or remediable through comprehensive, regular eye examinations, and because eye examinations frequently reveal general medical problems that have not yet been diagnosed (including diabetes).

Beyond diabetic retinopathy and other diabetes-related eye diseases, there are numerous conditions which steal away many American's precious vision: macular degeneration, glaucoma, cataract, high blood pressure, multiple sclerosis, and amblyopia ("lazy eye") are among the leading causes of vision loss in our country. Contrary to popular belief, many of these conditions - like diabetes - can strike any one, at any age, and at any time. Early diagnosis of eye diseases and conditions is critical to preventing vision loss but so, too, is educating patients about the connection between eye health and general health, as well as the importance of regular preventive eye examinations. Amblyopia, the leading cause of visual impairment in children, is a perfect case in point.

Amblyopia refers to less than normal vision in one or both eyes that is not due to eye disease and is not correctable by eyeglasses, contact lenses, or laser refractive surgery (e.g. LASIK). The two most common causes of amblyopia are strabismus (crossed or wandering eyes that may be too subtle for parents, school nurses and even pediatricians to notice), and unequal prescriptions between the two eyes (something only detectable by an eye doctor), and amblyopia almost always develops in early childhood (between birth and five years of age). Left undetected, amblyopia results in poorer reading skills and poor depth perception, factors that can hinder learning, the ability to play sports, or the ability to get a driver's license, and severely restrict a person's chances of getting many jobs requiring excellent binocular (two-eyed) vision.

More than 3% of all children (1 in 30) are affected by amblyopia, but research shows that most cases are correctable if diagnosed early (before age 2) and treated aggressively with a combination of optical correction (eyeglasses or contact lenses), occlusion therapy (patching the better seeing eye, thereby forcing the brain to use and strengthen the weaker eye) and vision therapy (eye muscle and brain exercises designed to make the brain use both eyes at the same time). Unfortunately, a majority of children with amblyopia do suffer life-long visual impairment because they are not diagnosed at an early age (when treatment is most successful) and/or will not receive ongoing care from a vision specialist. This is a genuine tragedy in a nation blessed with so many wonderful eye doctors and in a society which places so much value on the welfare of our most vulnerable members – our children. In an effort to address this problem, the American Optometric Association and its member eye doctors have launched a program, called InfantSEETM, which provides a comprehensive infant eye assessment within the first year of life as a no-cost public health service. Former President Jimmy Carter is the National Chair and spokesperson for this campaign.

So what does all this have to do with diabetes? People with diabetes have no more risk of developing amblyopia than do other people, but neither do they or their children have any less risk. Although diabetes is my specialty, not a day goes by that I don't examine a patient with poor vision from untreated amblyopia, and I am quite sure that every reader of dLife has a family member or friend with a child who has been affected or will be affected – just as is the case with diabetes itself. Because we are faced with the risk of vision loss and know the importance of preventive care, I think those of us with diabetes are poised to be particularly good advocates for others who face vision loss from diabetes - or any cause - most especially our children. If every parent and grandparent put a priority on early detection of eye and vision disorders and preventive eye care, our children and grandchildren would benefit greatly. Please, spread the word.

For more information on diabetic eye disease, consult Dr. Chous' book Diabetic Eye Disease: Lessons From a Diabetic Eye Doctor, Fairwood Press, Seattle, 2003.

Read more about Dr. Chous here.

Visit Dr. Chous' website here.


NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: June 28, 2013

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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