Diabetes is a leading cause of blindness. Those who live with diabetes may be experiencing vision loss and may not be aware of it. Screening is free for those with diabetes and individuals should be screened every year.
- In North America eye disease due to diabetes is the leading cause of preventable blindness in people between 30-69 years of age.
- Diabetic retinopathy is an eye condition that affects 500,000 Canadians.
- Diabetic eye damage: called diabetic retinopathy, this effect of diabetes on the eyes is the most common cause of blindness in people under age 65 and the most common cause of new blindness in North America.
- It is estimated that approximately 2 million individuals in Canada (i.e. almost all people with diagnosed diabetes) have some form of diabetic retinopathy.
As part of a partnership project funded by the Southwest Local Health Integration Network, St. Joseph’s’ Health Care London embarked on a pilot awareness campaign about the need for people living with diabetes to get their eyes checked regularly.
“It is so important people with diabetes get their vision screened. Vision loss can be sneaky and people who have diabetes, who feel perfectly healthy, may not even realize they have an issue,” says London, Ontario optometrist, Dr. Harry Van Ymeren. “In my practice I have seen it many times, people think they are fine and then we discover a problem. The point of screening is to catch it before it becomes too late and treatment is less or not effective.”
Diabetes is a chronic disease that prevents the body from making or using insulin, which in turn leads to increased sugar levels in the bloodstream, known as high blood sugar. The development of early-onset cataracts and glaucoma is more likely in people who have diabetes but the main threat is the effect of diabetes on the retina, the part of the eye that allows you to see.
“This is why screening early and often is so important for those with diabetes,” says Dr. Tom Sheidow, ophthalmologist at the Ivey Eye Institute, part of St. Joseph’s Health Care London. “Diabetes can affect all blood vessels in your body, including those inside your eye. Diabetic eye damage, also called diabetic retinopathy, occurs when there is a weakening of the blood vessels in the retina that can result in swelling of the retina, the abnormal growth of blood vessels and potentially severe bleeding. If diabetic retinopathy is left untreated, blindness can result.”
It is estimated that approximately two million people in Canada have some form of diabetic retinopathy, and it is the most common cause of blindness in people under age 65 and the most common cause of new blindness in North America.
Sarah MacArthur was diagnosed with type 1 diabetes at the age of three and as an adult is very cautious with her care. “Sarah is the exception to the rule,” says her optometrist, Dr. Van Ymeren. “She ensures she is always proactive and careful and understands the importance of screening. I wish more people who live with diabetes were as diligent.”
In the past three to four years, and only because she has regular screenings, Sarah and her doctor have been seeing some symptoms of diabetic retinopathy. “I had no signs at all,” says MacArthur. “There was nothing that prompted me or made me think something was wrong with my vision. But because of the screenings I do regularly Dr. Van Ymeren found some early indications. At the moment we are keeping a close watch on any changes and keeping up with the screening so that we know immediately if there is anything concerning.”
In the early stages of retinopathy there may be no symptoms at all,” says Dr. Van Ymeren. “That is why it is vital to have regular eye exams.”
Help is simple.
A routine eye examination can diagnose potential threatening changes that can cause blindness. However once damage has occurred, the effects can be permanent.
Controlling diabetes also minimizes the risk of developing retinopathy.
“People who feel completely healthy are the focus of this diabetes vision screening awareness campaign,” says Dr. Sheidow. “Anyone with diabetes should have their vision checked. Individuals with diabetes, both type 1 and type 2, are at risk for diabetic retinopathy.”
Seeing an eye care provider is easy.
Anyone can see an optometrist; referrals from a family doctor are NOT required. There are many online resources to locate an optometrist. Check out opto.ca to find an optometrist, look in the phone book or call a family doctor. For communities without an optometrist seeing an ophthalmologist is an option as well.
“It doesn’t matter if you see an ophthalmologist or an optometrist, as long as you get your eyes checked,” says Dr. Van Ymeren. “Yearly screening is free for people with diabetes.”
In Ontario, for people living with diabetes, the cost of an eye exam by an optometrist or ophthalmologist is covered through OHIP. Should your optometrist feel more extensive diagnostic tests are needed for a comprehensive exam there may be a fee associated with those tests - as they are not covered by OHIP. However, if you choose, those tests can be performed by an ophthalmologist. Ophthalmologist fees for additional diagnostic tests are covered by OHIP.
For more information about diabetic eye damage and where to find a doctor visit: www.diabetesvisionscreening.ca.