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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
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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 See Me Now?
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