Eye doctors are uniquely positioned to detect diseases affecting the entire body, such as diabetes, high blood pressure and atherosclerosis.

A complete eye examination includes careful investigation of the blood vessels coursing through the retina. Because the retina is a transparent tissue, these can be observed without invasive imaging or surgery, offering early clues to the health of the blood vessels throughout the body. As a result, regular eye examinations are a critical part of the management of any vascular disease – of which diabetes is of particular interest.

Currently, one in 12 people in the United States has diabetes, and an estimated 1/3 of individuals older than 20 are pre-diabetic. Diabetes is characterized by an impaired ability to metabolize glucose, a primary source of energy in the body. Over time, excess glucose in the bloodstream causes irreversible damage to blood vessels and nerves throughout the body, resulting in loss of tissue function.

Certain organs, such as the eyes and kidneys, are at increased risk of damage from diabetes. In the eye, elaborate networks of small blood vessels supply oxygen to light-sensitive nerves in the retina. Injury from diabetes impairs retinal health and can result in profound vision loss. In fact, diabetes is the leading cause of new cases of blindness among working-age adults, yet many patients with diabetes remain unaware of how the condition affects their eyes – and many have never had an eye exam at all.

The threats to vision from diabetes come from two main sources, growth of abnormal blood vessels in response to tissue damage and damage to the macula (the area of best central vision) from tissue swelling or oxygen deprivation. Growth of abnormal blood vessels in diabetics may result in bleeding into the back portion of the eye, detachment of the retina, or blockage of fluid outflow leading to glaucoma from uncontrolled eye pressure.

Because of these significant threats to vision from diabetes, the American Diabetes Association strongly recommends yearly dilated eye exams for all Type 2 diabetics, and for Type 1 diabetics after three to five years of diagnosis. Damage to the eye is clinically visible in 40 percent of Type 2 diabetics at the time they are diagnosed with diabetes, and within 20 years of diagnosis, nearly 1/4 of Type 2 diabetics and 1/2 of Type 1 diabetics require treatment by laser or injection of medication into the eye to prevent severe vision loss.

Those seeking to lower their risk of vision loss from diabetes should consider taking the following steps

andbull; Maintaining recommended control of blood glucose levels through diet, exercise, and medications;

andbull; Lowering blood pressure;

andbull; Quitting smoking; and

andbull; Having yearly dilated eye examinations with an optometrist or ophthalmologist to detect early signs of eye complications and facilitate timely treatment when needed.

Although diabetes is a chronic and challenging condition, appropriate lifestyle changes, regular examinations and medical therapy can combine to ensure a future of good health and minimize the potential consequences of the disease.

Dr. David Glabe in an optometristat La Grande Family Eye Care