AAOpt 2025: Diabetes case studies with an eye to the future

Julie Rodman, OD, MS, FAAO, discussed a presentation on diabetes and diabetic eye disease delivered with A. Paul Chous, MA, OD, FAAO. The presentation comprehensively covered multiple aspects of diabetes, focusing on its epidemiology, pathophysiology, and emerging treatments, with a specific emphasis on the critical role optometrists play in managing diabetic patients. Rodman highlighted the complexity of diabetes, noting it rarely exists in isolation. She described a common "triad" where diabetic patients often simultaneously experience high blood pressure and high cholesterol, which significantly complicates disease management. The presentation drew from real-world clinical experiences, presenting case studies that illustrated various patient scenarios and management strategies. A significant portion of the discussion centered on healthcare access challenges. Rodman described working with an indigent population where patients often arrive with end-stage disease, potentially facing imminent blindness. Barriers to proper care include limited healthcare access, financial constraints, lack of transportation, and insufficient patient education. Rodman emphasized the importance of patient education, recognizing that primary care physicians often lack time for comprehensive disease explanation. Optometrists have become crucial in bridging this educational gap, taking time to:

• Explain disease progression
• Use visual models demonstrating retinal changes
• Discuss potential complications
• Provide emotional support and reassurance

Rodman highlighted that disease duration is a primary risk factor for diabetic retinopathy, explaining to patients that developing complications isn't necessarily their fault but a natural progression of long-term diabetes. The presentation also addressed comanagement strategies, particularly referral options. In Rodman's region, Bascom Palmer Eye Institute serves as an excellent resource, providing treatment regardless of a patient's financial situation. Key takeaways included the critical need for:

• Regular eye examinations
• Patient education
• Comprehensive disease management
• Accessible healthcare resources

Rodman and Chous portrayed optometrists as essential healthcare providers who not only diagnose and treat diabetic eye conditions but also serve as patient educators and advocates in managing this complex chronic disease.