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Diabetes and the Eye
By Louis A. Lobes, Jr., M.D.

It has been estimated that 11 percent of people over 20 years of age in the United States have some form of diabetes and the three out of five people with diabetes will suffer from a complication of the disease. Diabetic retinopathy is an important such complication. It is a leading cause of new cases of legal blindness among working-age Americans and represents a leading cause of blindness in this age group worldwide. The estimated number of cases of retinopathy for all adults with diabetes aged 40 and older in the United States is 28.5 percent, or 4.2 million people. It is estimated that the number with of patients with vision-threatening diabetic retinopathy in the United States is 4.4 percent, or 700,000 people, and the approximate number by the year 2020 may rise to 1.6 million patients.

To try and lower the risk of developing progressive retinopathy and suffer visual threat, patients must recognize the most significant risk factors for the development of retinopathy of diabetes. The most important seem to be the duration of the illness, the control of the blood sugar to near normal levels, and HgbA1C level of 7 percent. Less well documented assumed risk factors include hypertension, serum lipids, level of activity, and obesity. It should make good sense for any diabetic patient to control these additional medical issues as best as possible.

Even with success in managing the diabetes itself, diabetic retinopathy can still be present. It progresses in step-like stages when not treated and so it is most important that all diabetic patients receive a comprehensive eye exam annually. There are excellent treatments available for all the stages of retinopathy and the earlier the diagnosis the better the visual prognosis. Several decades of clinical research have provided excellent data on the natural course of the disease and on treatment strategies that are 90 percent effective in preventing the occurrence of severe vision loss.

If a diabetic is found to have beginning retinopathy, they should follow the recommendations of their eye care professional as more frequent exams may be required. The prognosis, however, is much improved over the past and the prognosis is good if the patient adheres to control of the risk factors and regularly scheduled comprehensive eye examinatons.

Louis A. Lobes, Jr., M.D., a board certified ophthalmologist in Pittsburgh, Pennsylvania, is board chairperson of Blind & Vision Rehabilitation Services of Pittsburgh, a nationally accredited, 106-year-old private nonprofit leader in programs and services for people of all ages who are blind, vision impaired, or have other disabilities. Its mission is to change the lives of persons with vision loss and other disabilities by fostering independence and individual choice. Blind & Vision Rehabilitation Services offers comprehensive and personalized computer instruction, employment and vocational services, adjustment to blindness training, in-home instruction, low vision services, vision screenings for children and adults, and an industrial employment program. Employment support services are offered in Fayette, Greene, and Washington counties, and in Somerset County children vision screenings, transportation services, and support groups are available. BVRS is accredited by the National Accreditation Council for Blind and Low Vision Services (NAC).

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