As previously discussed in Lifelines, diabetic retinopathy is among the reasons why eye exams should be a regular part of your preventive health care.

Did you know that you could be losing your vision to diabetes or prediabetes and not know it? Diabetic retinopathy, a common complication of these conditions, is a leading cause of blindness and can show no symptoms for years. Since diabetes and prediabetes can also cause no symptoms in the early stages, a routine eye exam could be the first indication that you have one of these conditions.

Diabetic Retinopathy

Diabetic retinopathy occurs when high blood sugar causes an overgrowth of tiny blood vessels in the retina, the thin layer of tissue lining the back of the eye. Without treatment, which may include medication and/or surgery, diabetic retinopathy can cause:

• Vitreous hemorrhage: New blood vessels bleed into the clear, jelly-like substance that fills the center of the eye, causing dark spots (floaters) or sometimes completely blocking vision.
• Retinal detachment: Overgrowth of blood vessels leads to scar tissue, which pulls the retina away from the back of the eye and causes spots in vision, flashes of light or severe vision loss.
• Glaucoma: New blood vessels interfere with the normal flow of fluid out of the eye, causing pressure to build and damaging the optic nerve that carries images from the eye to the brain.
• Blindness: Diabetic retinopathy and glaucoma can both lead to complete vision loss.

Anyone who has diabetes or prediabetes can develop diabetic retinopathy, but certain factors increase this risk. These include:

• The longer you have diabetes or prediabetes
• High blood pressure
• High cholesterol
• Pregnancy
• Tobacco use
• Being African American, Latino or Native American

To reduce the risk of vision loss, the American Diabetes Association (ADA) recommends:

• Adults with type 1 diabetes get a dilated and comprehensive eye exam by an ophthalmologist or optometrist within three to five years of being diagnosed with diabetes.
• Patients with type 2 diabetes get a dilated and comprehensive eye exam by an ophthalmologist or optometrist at the time of diagnosis. A dilated exam involves placing drops in each eye that widen the pupil, allowing in more light and making it possible to see the tissues at the back of the eye, including the retina, macula and optic nerve, with an ophthalmoscope.

After the initial exam, the ADA recommends an annual eye check, though some people may need more frequent exams depending on their condition. The earlier diabetes and prediabetes are diagnosed, the better they can be managed and their damage minimized.

If you have diabetes or prediabetes, you can reduce your risk for diabetic retinopathy through careful management of your condition. If you have been prescribed a medication, it’s important that you are compliant. This includes maintaining a healthy weight, eating a healthful diet, engaging in regular exercise and if you smoke, quitting. Pay close attention to changes in your vision and contact your eye doctor right away if you notice spots or if your vision becomes blurry.

The LHSFNA has a number of materials that can help Laborers reduce their risk for diabetes or manage diabetes if they already have it. These include the Diabetes Health Alert and the Becoming Physically Active and Weight Matters pamphlets. You can order through our online Publications Catalogue.

The Fund can also coordinate a health fair for Laborers to have basic screenings for blood pressure, glucose and cholesterol. For more information, call 202-628-5465.

Future articles in Lifelines will explore other common conditions that can affect vision in more detail.

[Janet Lubman Rathner]