Diabetes

Here’s Why People With Diabetes Shouldn’t Skip Eye Appointments

Written By: Susanne Medeiros Reviewed By: Mark W Johnson BA, Jason Hsu . Nov. 30, 2018

If you develop proliferative diabetic retinopathy, a blinding eye disease caused by diabetes, ophthalmologists have two treatment options: Lasers or needles.

Proliferative diabetic retinopathy happens when abnormal new blood vessels grow inside the eye, potentially leading to bleeding or retinal detachment, which can cause vision loss. The goal of treatment is to stop the growth of those blood vessels and prevent vision loss. Traditionally, ophthalmologists have used a laser to make tiny burns in the retina, which cause the abnormal blood vessels to shrink and prevent them from growing again.

Recently, ophthalmologists began using another method – injecting a medication directly in the eye. This approach, called anti-VEGF therapy, also helps stop the blood vessels from growing or leaking.

Both methods can control blood vessel growth and preserve vision. But researchers are now finding that there may be an important difference between these treatments. It appears that people treated with injections alone need to be treated regularly and perhaps indefinitely to maintain their vision. That means no skipped appointments. Ophthalmologists say the consequence for interrupting this treatment is steep: potential blindness.

Problem is, many people with diabetes don’t see their ophthalmologists as regularly as they should. Things happen: appointments are forgotten, other health issues crop up, financial problems happen. But missing appointments may be more devastating to your vision if you are treated with injections alone compared with laser treatment, which typically controls the disease permanently.   

Two studies, conducted by ophthalmologists at Wills Eye Hospital and the University of Michigan Kellogg Eye Center, looked at  people who didn’t return to their physician for four to six months. Of those patients, those receiving treatment with injections alone suffered significantly more vision loss than those receiving laser treatment. One study showed that nearly half the patients who had a major interruption in anti-VEGF therapy suffered severe and often irreversible vision loss.

“It is critical for patients to understand that anti-VEGF drugs disappear from the eye within a month or two and do not have a lasting effect in most cases,” said Mark W. Johnson, MD, professor of Ophthalmology at the University of Michigan. “Patients receiving this form of treatment for proliferative diabetic retinopathy must continue to receive injections on a regular basis.  Otherwise, the disease may progress with sometimes blinding consequences.  In contrast, the beneficial effect of adequate laser treatment lasts indefinitely in most eyes.”

WHAT TO KNOW ABOUT COLOR BLINDNESS

What to Know About Color Blindness

Contrary to its name, color blindness does not mean that you cannot see any colors. You may see some colors just fine, but may be unable to distinguish between other colors.

What Causes Color Blindness?

Color blindness is usually inherited, although some conditions and diseases can also affect the way you see colors. When you are color blind, cones, special photoreceptor cells in your retina, do not work as well as they should. The retina is a layer of light-sensitive cells that lines the back of your eye. It sends visual signals to your brain, where they are interpreted as images. Although you may not be able to see some colors if you are color blind, the condition usually will not affect your overall vision.

What are the Types of Color Blindness?

Red-green color blindness is the most common form. People who have this type have varying degrees of difficulty telling the difference between red and green. Eight percent of men and .5 percent of woman of Northern European Ancestry have this deficiency, according to the National Eye Institute.

The condition is passed on to you from your mother, who carries a mutated gene on one of her X chromosomes. Women have two X chromosomes, while men only have one, which increases the risk that males who receive the mutated gene will develop the problem. If you are female and you receive a copy of the gene on one X chromosome, your healthy X chromosome can cancel out the damaged one. Males who have red-green color blindness can pass the gene on to their daughters.

Blue-yellow color blindness, the inability to distinguish between yellow and blue, is less common and equally likely in males and females because the defect is not located on the X chromosome. A very small percentage of people experience the complete loss of color vision, although this is very rare.

Does Everyone Experience Color Blindness the Same Way?

Different people may have very different levels of color blindness. One person may notice that red and orange colors have a green tinge, while others may see only black when they look at a red object. If you have no color vision, you may only see black, white and gray, and might only realize that something is a different color because it is darker or lighter than other objects.

What Can Be Done to Help People with Color Blindness?

There is no treatment or cure for color blindness currently, although researchers are conducting studies that may one day lead to a treatment or cure. If you have red-green blindness, your optometrist may recommend special lenses for your glasses that will make it easier to tell the difference between colors. As you can imagine, living with color blindness can create some challenges. You may not be able to see red warning lights, tell when the strawberries in your refrigerator have gone bad or realize that your clothes do not match. Luckily, several apps have been created to help people with color blindness recognize colors.

Are you concerned that you or someone you care about may suffer from color blindness? We offer color blindness testing that can help put your mind at ease. Call us today to schedule an appointment.

Increased Risk Factors for Color Blindness

Although most cases of color blindness are inherited, some people develop an acquired form of the disease. Risk factors for this type of color blindness include: Diseases. If you have leukemia, Alzheimer’s disease, diabetes, liver disease, glaucoma or macular degeneration, you may have an increased risk of developing some degree of color blindness. Trauma. Trauma to your brain or retina can cause color blindness. If you experienced shaken baby syndrome as an infant or received a blow to your head, you might develop an acquired case of color blindness. Retinal damage can occur for a variety of reasons, such as excessive exposure to ultraviolet light. Alcoholism. Alcoholism ups your chance of developing trouble distinguishing between colors. Cataracts. Cataracts can make colors look duller. Cataracts are usually related to aging and occur when the lens in your eye becomes cloudy. After cataract surgery, most people regain full color vision. Medications. Some medications can cause color blindness, including hydroxychloroquine, a prescription drug used to treat rheumatoid arthritis. If you notice any change in your color vision, see your optometrist immediately, as these changes can be a sign of a serious vision problem.

WHAT TO EXPECT DURING A ROUTINE EYE EXAM

What to Expect During a Routine Eye Exam

3 Signs Your Child Might Need to Visit the Eye Doctor

You are probably very familiar with your eyesight, but your children rely on you to help them understand what’s normal and what isn’t. As they grow and learn, they will become better at expressing their vision needs, but, in the meantime, keep an eye out for the following telltale signs that it’s time to take your child to the eye doctor: 1. Age. The No. 1 sign your child should see an eye doctor is age. Most doctors recommend that you take your child for an exam at 6 months, 3 years old and before starting first grade. 2. Squinting. If your child has difficulty reading, focusing or appears to be squinting when reading or watching television, it may be time for an eye exam. 3. Signs of External Irritation.Keep an eye out for signs of external irritation, such as rubbing and itching, redness and excessive eye mucous or discharge. These may be signs your child needs to see an eye doctor. If you child has any of the signs above or if your child is overdue for their routine eye exam, contact us to schedule an appointment.

What to Expect During a Routine Eye Exam  

Routine eye exams are straightforward, quick and painless. Most doctors recommend screening your vision on an annual basis to ensure your vision prescription is up to date (or to determine you need one) and to make sure your eyes are healthy. Regular eye exams are the first line of defense against eye disorders, such as chronic dry eye, inflammation, glaucoma, age-related issues and cataracts.

During a regular visit, you can expect your optometrist to perform the following tests to determine your eye health:

Pre-Exam Tests. A technician will often perform a few basic tests before you see the doctor, including a color sensitivity test, peripheral vision test, a glaucoma (or “air puff” test) and a cover test to determine how well your eyes work together. He or she may also use an autorefractor, which automatically measures your vision prescription, to gain a ballpark understanding of your vision needs.

Pupillary Reactions. Using a light, the doctor checks your pupils’ responsiveness. Your pupils’ response to light is a natural function of the eye and is critical to your vision. While using the light, the doctor will also look at the surface of your eye for signs of dry eye, corneal scratches and bacterial debris.

Slit Lamp Test. During a slit light test (also called a biomicroscope), the doctor will shine a vertical bar of light into your eye to magnify your eye’s surface and inspect for abnormalities on the cornea, iris and lens. This test usually takes a few minutes, and you may be asked to blink or stare at your doctor’s ear so he can look closely at your eye’s surface.

Visual Acuity and Refraction. The most well-known part of the eye exam is the visual acuity test. Your doctor will ask you to read an eye chart filled with numbers and letters with one or both eyes. Your ability to clearly read and identify the numbers and letters helps the doctor further determine your vision prescription needs. To hone in on your exact prescription, your doctor will place a large lens refractor in front of you and ask you a series of questions about which lenses make your vision better or worse.

Pupil Dilation. At the end of your exam, the doctor may ask you if you would like to have your eyes dilated. By dilating your eyes, the doctor can examine your retina and optic nerve more fully. To perform this part of the exam, the doctor will put a few drops in your eyes that cause your pupils to enlarge, letting more light in and giving him or her a better view into your eye. Your eyes may be sensitive to light for up to an hour after the test, so it’s best to avoid being outside in direct sunlight afterward.

WHAT IS RETINAL DETACHMENT?

What is Retinal Detachment?

A detached retina is an serious medical emergency that can lead to permanent vision loss if it is not treated promptly. Thanks to innovative treatment options, many people who suffer from retinal detachment can maintain useful vision. Learning about retinal detachment symptoms can help you react quickly if you or a friend or family member ever experience this vision problem.

What Happens During a Retinal Detachment?

The retina is a thin layer of light-sensing cells that lines the back part of the inside of your eye. The retina turns light into signals that are transmitted via the optic nerve to the brain, where they are converted into images. A retinal detachment occurs if all or part of the retina begins to pull away from the back of eye. When this happens, the retinal cells no longer receive oxygen from the blood vessels in the eye and may eventually die if you do not receive emergency treatment.

What Are the Symptoms of Retinal Detachment?

Retinal detachment does not cause any pain, but can cause one or more of these symptoms:

• Floaters. These tiny, string-like fibers seems to float through your field of vision. Although it’s not unusual to see one or two float by occasionally, if you suddenly notice many floaters, you may have a retinal detachment.
• Light Flashes. Flashing lights can occur when the retina separates from the back of the eye.
• Dark Curtain. During a retinal detachment, you may notice that a dark curtain impairs all or part of your vision. The dark area can grow larger if the detachment gets worse.

How Are Detachments Treated?

A retinal detachment is always a medical emergency. If you experience any of the above symptoms, call your eye doctor or go to the emergency room immediately. Doctors typically perform two types of surgery to repair the retinal detachment. Laser surgery is used to create tiny burn areas around the detached area to help fuse it back into place, while cryopexy is a technique that uses freezing cold temperatures to seal the edges of the retina.

Your doctor may also use a procedure known as pneumatic retinopexy to repair the tear. During this procedure, your doctor injects a small bubble of air or gas into your eye, which then seals the tear. If fluid from the vitreous, the clear gel that gives your eyeball its shape, accumulates under the torn area, your doctor may perform a vitrectomy. During the procedure, the fluid is drained, inject air or gas is injected to seal the tear, and the eye is refilled with liquid.

Some people who have retinal detachments benefit from scleral buckling. During this procedure, a small piece of silicone rubber or a sponge is sewn in place over the sclera, the white part of your eye. The scleral buckle pushes the white part of your eye inward, which helps the retina move back into its usual position against the back of your eye. Scleral buckling is usually combined with cryopexy or laser surgery.

Regular examinations are the key to maintaining good eye health. Call us today and schedule your next appointment.

Who Is at Risk for Retinal Detachment

Certain people are at higher risk for retinal detachment than others. You may be at increased risk if you: Had a recent eye injury Are very nearsighted Have diabetic retinopathy. If you have this condition, fluid from leaking blood vessels can accumulate under the retina. Recently had cataract surgery Are related to someone who has had a retinal detachment or have already had a retinal detachment in your other eye Have another eye disease or disorder, including lattice degeneration, retinoschisis, uveitis or another inflammatory disorder. These diseases can cause fluid to build up under your retina even if you don’t have a tear.

VISION CHARITIES TO HELP YOU GIVE BACK THIS HOLIDAY SEASON

Vision Charities to Help You Give Back This Holiday Season

Imagine trying to succeed at work at school if you could not see clearly. Unfortunately, that’s the reality for far too many people in the world. Whether they cannot afford eye care, are blind or have a vision disability, poor eyesight makes life much more difficult. You can make a difference this holiday season by supporting one of the following vision care charities.

American Foundation for the Blind

The AFB helps blind and visually impaired people enjoy full lives. The national non-profit organization is committed to improving access to technology and helps people find the services and products they need.

Blinded Veterans Association

The Blinded Veterans Association, formed by blind World War II veterans, advocates for and assists blind veterans. The organization’s Field Service Program helps veterans navigate the Veteran’s Administration claims process while another program helps newly blind veterans adjust to life without sight.

Choroideremia Research Foundation

Choroideremia is an inherited disorder of the retina that causes gradual vision loss and, eventually, blindness. The Choroideremia Research Foundation raises money to support research that will hopefully lead to a treatment or cure.

Council of Citizens With Low Vision International

The Council of Citizens With Low Vision International is an advocacy organization that educates the public about the capabilities of the visually impaired and establishes outreach programs that ensure that everyone has access to services.

Delta Gamma Center for Children With Visual Impairments

Early identification of visual problems is the key to helping children make the most of their usable vision. The Dental Gamma Center for Children With Visual Impairments offers low-vision evaluations, early intervention services, orientation and mobility training as well as occupational, physical and speech therapies.

Foundation Fighting Blindness

The Foundation Fighting Blindness raises money to support research that’s devoted to the study of retinitis pigmentosa and other related retinal diseases. They also provide support and information to people affected by these diseases.

Glaucoma Research Foundation

The Glaucoma Research Foundation funds research in support of better treatments for glaucoma and provides education and support.

Leader Dogs for the Blind

Established in 1939, Leader Dogs for the Blind has a long history of helping visually impaired people become self-sufficient. Clients are matched with guide dogs that help them live more independent lives.

Macular Degeneration Association

Macular degeneration, the loss of central vision, predominantly affects senior citizens; although people of all ages can be affected. The Macular Degeneration Association supports research and offers information to people affected by the disease.

Optometry Cares – The American Optometric Association Foundation

Optometry Cares was established to ensure that all Americans have access to vision care. The charity offers the infantSEE program, a free program that provides eye care to infants and provides free basic vision services to low-income, uninsured people through the VISION USA program.

Restoring Vision

This non-profit organization provides sunglasses and new reading glasses to underprivileged people in the U.S. and developing nations. In the last decade, Restoring Vision distributed 3,000,000 new pairs of glasses and sunglasses.

Volunteer Optometric Services to Humanity/International

Volunteer Optometric Services to Humanity (VOSH)/International supports eye clinics, optometry schools and optometric educations in underserved areas throughout the world. More than 100,000 people yearly receive eyeglasses, treatment or vision surgery every year thanks to VOSH/International.

3 Reasons to Visit Your Optometrist by the End of the Year

The end of the year is fast approaching, and there is no better time to visit your optometrist. Not convinced? These three reasons may change your mind. You Won’t Waste Your FSA Balance Don’t lose the money remaining in your flexible spending account (FSA). Use it for an eye exam or new pair of glasses or contacts. Although some employers extend the FSA deadline to March, others are firm about the December 31stdeadline. If you don’t use your FSA funds by your employer’s due date, you will lose the remaining balance. Why not make an appointment now and avoid worries about missing the deadline, whenever it may be? You Just Might Find a Great Deal on Eyewear A new year means a new selection of frames, but it also often means there’s not enough room to display them in your optometrist’s office. Holiday shopping deals are not just limited to big-screen TVs; your optometrist may also offer deals you won’t want to pass up. You’ll Start the New Year off Right Cross off a few of your New Year’s resolutions a little early. Don’t put off making that visit to your optometrist a minute longer. Even slight changes in your prescription can affect your vision. After your visit, you will be able to face the New Year with crystal clear vision and a fashionable new pair of frames. Ready to make your eye care appointment? Contact our office today!