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Blindness Risk
Diabetic eye disease, caused by diabetes, is a leading cause of
blindness and vision loss.
-Prevent Blindness America
Diabetic Eye Disease
• Diabetic Retinopathy– Damage to blood vessels in retina
• Cataracts– Clouding of the lens in the eye,
more likely to develop
earlier with diabetes
• Glaucoma– Damage to nerves and optic nerve causing vision loss; nearly twice as
likely to develop with diabetes
-National Eye Institute
Diabetic Eye Disease
• MEDICAL condition
• Eye health examinations, treatment, progression monitoring are covered by
MEDICAL INSURANCE
Thus can be billed to Medicare/Medicaid, Blue Cross, Aetna, Regence….etc…..
Diabetic Retinopathy (DR)
• What is diabetic retinopathy?
• What are the stages of damage?
• What is the treatment?
• What are the risk factors?
• What should I do?
What is Diabetic Retinopathy?
• Damage to the small blood vessels in the retina.• Weakening of the blood-retina barrier causing leakage, thickening, swelling, ischemia (lack of oxygen), and other damage
Stages of Diabetic Retinopathy
• Mild Nonproliferative Diabetic Retinopathy
• Moderate Nonproliferative DR
• Severe Nonproliferative DR
• Proliferative DR
• With or without Clinically Significant Macular Edema
Mild Nonproliferative DR
• Earliest Stage• “Dot/blot”
hemorrhages• Microanuerysms• No treatment• Regular dilated
eye exams
Moderate Nonproliferative DR
• Lack of oxygen and nutrients
• Possible blockage of vessels
• More progressed
Severe Nonproliferative DR
• More significant damage in retina
• Similar vascular damage, more severe
Proliferative DR
• Ischemia, significant lack of oxygen and nutrients
• New blood vessel growth (neovascularization)
Diabetic Macular Edema
• Swelling of the macula
• May be evident at any stage of diabetic retinopathy
• Requires treatment
• Central Vision
Treatment
• Laser treatment– Focal laser treatment – specific spots of laser– PRP – Panretinal Photocoagulation –
scattered laser• Laser to retina that causes scarring• Reduces demand for oxygen to retina
Treatment continued…
• Vitrectomy – exchange of fluid in vitreous– Removes blood from vitreous
• Injections– Anti-VEGF Injections –
Vasoendothelial Growth Factor
• Causes new blood vessel growth to stop and even some reversal.
– Steroid Injections – Occasionally used for edema
Risk Factors
• Duration of diabetes
• Poor blood sugar control
• Hypertension
• High cholesterol
• Smoking
• Pregnancy
Take Home
• Annual Dilated Eye Examination,regardless of visual acuity
• Diet, healthy nutritional guidelines
• Exercise regularly
• No smoking
• Medical eye exams = Medical Insurance