Individuals living with diabetes may be experiencing vision loss and not know it. In the early stages the signs often go unnoticed.
Screening is readily available and free for those with diabetes, yet, on average, only slightly more than half of people living with diabetes in the London region regularly have their vision checked. That figure plummets to 33 per cent for those ages 18 to 39. With eye disease due to diabetes the leading cause of preventable blindness (ages 30-69) in North America and the leading cause of blindness in Canada, the screening rates are cause for alarm.
St. Joseph’s Health Care London, in partnership with the Southwest Local Health Integration Network (LHIN), is taking aim at the problem, embarking on a pilot awareness campaign called the Diabetes Vision Screening program. The program focuses on the importance of regular eye screenings for those with diabetes.
"Vision loss can be sneaky and people who have diabetes, who feel perfectly healthy, may not even realize they have an issue,” says London optometrist, Dr. Harry Van Ymeren.
“Vision loss can be sneaky and people who have diabetes who feel perfectly healthy may not even realize they have an issue.” —Dr. Harry Van Ymeren, optometrist.
“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 St. Joseph’s Ivey Eye Institute. “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, abnormal growth of blood vessels and potentially severe bleeding. If diabetic retinopathy is left untreated, blindness can result.”
Many are unaware of this frightening fact. In a survey conducted as part of the Diabetes Vision Screening program, 31 per cent of patients surveyed did not know that diabetes was the leading cause of blindness.
It’s estimated that two million people in Canada have some form of diabetic retinopathy, 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 age 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 four years, and only because she has regular screenings, Sarah and her doctor have noted some symptoms of diabetic retinopathy.
“I had no signs at all,” says Sarah. “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 screenings so 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 for those with diabetes to have regular eye exams.”
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 new 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. For communities without an optometrist, visiting 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 the 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, 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
Just the facts
- A recent Health Quality Ontario report indicates that 85,752 people live with diabetes in the South West LHIN and of that number only 48,879 people are having regular eye examinations.
- The Institute for Clinical Evaluative Sciences Western assessed screening rates for 2013-2014 in the South West LHIN as follows:
- 57 per cent (48,879 people) living in the South West LHIN had diabetic vision screening completed.
- By age group, the screening rates were: 33 per cent for ages 18-39; 49 per cent for ages 40 to 65; and 68 per cent for those over age 66.
- Eye disease due to diabetes is the leading cause of preventable blindness (ages 30-69) in North America and is a leading cause of blindness in Canada.
- Diabetic eye damage affects approximately two million people in Canada. (World Health Organization, Canadian Diabetes Association, Canadian National Institute for the Blind)