Diabetic Eye Disease

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Eyecare practitioners who deal with patients in the perioperative period are well aware of the need for topical therapy. In most cases, a combination of a steroid, a nonsteroidal anti-inflammatory drug (NSAID), and an antibiotic will be used for a few days before the day of surgery and then for a period afterward.

In the city of Chicago, there’s a 95-year-old retired pathologist and professor with a wry smile on his face. More than 50 years ago, Joseph Kraft, MD, identified that many tinnitus patients were in fact pre-diabetic.1 Back then this was a leaner America, and far fewer citizens had diabetes. Of course, much has radically changed.

Mass media and medical publications have been warning for years that the incidence of diabetes is rising rapidly and predicting a “health catastrophe” in which more than 10 percent of the U.S. population would be living with this disease.

Fifty years of dietary guidelines have emphasized “low fat” and “low cholesterol” eating, so manufacturers obliged by creating foods with increasing sugar and wheat/gluten content while promoting exercise and widespread use of statins to lower cholesterol. Yet Americans have become overweight, obese, and typically less healthy at an alarming rate. The newest 2015-2020 U.S. dietary guidelines, eighth edition, are attempting to address this issue by limiting “added sugar.”1

A new study recently published in Retina found that communication between a diabetic patient’s eyecare provider (ECP) and primary care physicians (PCPs) increased the likelihood that the patient would make and keep her eye exam appointment.

From new ways of predicting who will and won’t develop diabetes, to new diabetes meds, to new evidence regarding which anti-vascular endothelial growth factor (VEGF) might be better for your specific patient, the last year has given us better tools for helping our patients with diabetes.

Recently, a colleague wrote me to express his concern about a primary care physician (PCP) in his community acquiring digital retinal photographs of his diabetes patients. One of those patients presented to the optometrist’s office with the impression that “all he needed was a refraction” since the PCP had “already checked him for diabetic retinopathy.”

A 76-year-old white female presented for her periodic diabetic eye examination at UAB Eye Care in July 2014. She admitted to blurry vision in her left eye for approximately one week.

According to the National Eye Institute (NEI), 7.7 million people age 40 and older have diabetic retinopathy, and this number is projected to increase to approximately 11 million people by 2030.

During the American Academy of Optometry's Academy 2014, presenters shared how optometrists can help halt the diabetes epidemic and combat associated ocular complications.

A study recently published in Diabetes Care found that methazolamide (Neptazane, Fera) significantly lowered HbA1C levels in patients with type 2 diabetes.

A cataract is a clouding of the crystalline lens, resulting in vision loss. There are different types of cataracts, and they may be associated with underlying conditions. Understanding the differences between types of cataracts will improve clinical management of your patients.

I sometimes wonder why, in the rush to build the medical model, so many of my colleagues seemingly abandon the retail aspects of our profession. Many ODs seem to want to forget or diminish that our historical contribution to vision has been mainly centered around the correction, refractive, and binocular vision function and development.