Diabetes and the Eyes

Kenyon Anderson, O.D.

Blindness Risk

Diabetic eye disease, caused by diabetes, is a leading cause of

blindness and vision loss.

-Prevent Blindness America

Diabetic Eye Disease

• Diabetic Retinopathy– Damage to blood vessels in retina

• Cataracts– Clouding of the lens in the eye,

more likely to develop

earlier with diabetes

• Glaucoma– Damage to nerves and optic nerve causing vision loss; nearly twice as

likely to develop with diabetes

-National Eye Institute

Diabetic Eye Disease

• MEDICAL condition

• Eye health examinations, treatment, progression monitoring are covered by

MEDICAL INSURANCE

Thus can be billed to Medicare/Medicaid, Blue Cross, Aetna, Regence….etc…..

Diabetic Retinopathy (DR)

• What is diabetic retinopathy?

• What are the stages of damage?

• What is the treatment?

• What are the risk factors?

• What should I do?

What is Diabetic Retinopathy?

• Damage to the small blood vessels in the retina.• Weakening of the blood-retina barrier causing leakage, thickening, swelling, ischemia (lack of oxygen), and other damage

Stages of Diabetic Retinopathy

• Mild Nonproliferative Diabetic Retinopathy

• Moderate Nonproliferative DR

• Severe Nonproliferative DR

• Proliferative DR

• With or without Clinically Significant Macular Edema

Mild Nonproliferative DR

• Earliest Stage• “Dot/blot”

hemorrhages• Microanuerysms• No treatment• Regular dilated

eye exams

Moderate Nonproliferative DR

• Lack of oxygen and nutrients

• Possible blockage of vessels

• More progressed

Severe Nonproliferative DR

• More significant damage in retina

• Similar vascular damage, more severe

Proliferative DR

• Ischemia, significant lack of oxygen and nutrients

• New blood vessel growth (neovascularization)

Diabetic Macular Edema

• Swelling of the macula

• May be evident at any stage of diabetic retinopathy

• Requires treatment

• Central Vision

Treatment

• Laser treatment– Focal laser treatment – specific spots of laser– PRP – Panretinal Photocoagulation –

scattered laser• Laser to retina that causes scarring• Reduces demand for oxygen to retina

Treatment continued…

• Vitrectomy – exchange of fluid in vitreous– Removes blood from vitreous

• Injections– Anti-VEGF Injections –

Vasoendothelial Growth Factor

• Causes new blood vessel growth to stop and even some reversal.

– Steroid Injections – Occasionally used for edema

Risk Factors

• Duration of diabetes

• Poor blood sugar control

• Hypertension

• High cholesterol

• Smoking

• Pregnancy

Take Home

• Annual Dilated Eye Examination,regardless of visual acuity

• Diet, healthy nutritional guidelines

• Exercise regularly

• No smoking

• Medical eye exams = Medical Insurance

THE END

THANK YOU

Any questions?