SUNDAY, July 22, 2001 (HealthDayNews) -- Call it shortsighted, but many diabetics fail to take the necessary precautions to preserve their vision.
That's the conclusion of a recent study that found more than one-third of diabetics don't adhere to vision-care guidelines established by both the American Academy of Ophthalmology and the American Diabetes Association.
The study, published recently in the journal Ophthalmology, asked 2,300 people with diabetes whether they had a yearly dilated eye examination, as is recommended. Thirty-five percent replied, "no."
The AAO president, Dr. George Blankenship, says his group suspects the number is even higher. "We believe the percentage of people with diabetes who obtain the recommended yearly eye examination with their pupils being dilated is probably less than 50 percent."
"And as best as we can tell from the available data, it's usually not just a failure to get an eye exam complete with the dilation -- necessary to evaluate for retinal damage -- but it's just a failure to get an eye examination altogether," he adds.
The study found that those with type 1, or insulin-dependent diabetes, were more likely to have the eye exams than those with type 2, or adult-onset diabetes.
Vision loss tends to be more severe in those with type 1 diabetes, experts say. But the threat still exists for those with type 2 diabetes, and failure to get exams could be devastating.
Diabetic retinopathy is the leading cause of new cases of blindness among American adults each year, accounting for 8,000 cases annually, according to the AAO.
Blankenship says one of the insidious aspects of diabetic retinopathy is that the initial symptoms can be subtle.
"The onset of changes to the blood vessels in the retinas is initially very gradual," he says. "And it's in those stages, before a person has lost vision, that laser treatment is most successful in preserving good functioning vision."
"All too often, however, the damage is occurring inside the eye without affecting a person's vision or causing any discomfort whatsoever," he adds. "And then they will have an abrupt, catastrophic loss of vision that can result in blindness."
Blankenship says the reasons people fail to follow the eye-exam guidelines are likely varied.
"There are probably hundreds of reasons why people don't get the regular exams -- not being aware of the importance of doing this, lack of insurance, and even denial that this could happen."
He adds there are also many people who don't want to be bothered with having their pupils dilated. "It can be kind of inconvenient. You can't really go back to work that day and you can't drive because your vision is blurred from the dilation."
Dr. John B. Jeffers, director of emergency services and resident education at Wills Eye Hospital in Philadelphia, says he sees diabetics who have obviously had the condition building for some time. But they only respond when it becomes an emergency.
"There will have been blurred vision, but some people will have just assumed that it was old age or they just would have been in denial," he says. "It's a shame, because nowadays the laser can do a lot to treat them, but the patient has to take responsibility for getting check-ups."
Jeffers adds that if many diabetics took better care of themselves, their vision problems could be prevented. "We do know that the better the diabetes is controlled, the less apt patients are to having problems, including eye problems."
What to Do: Visit the American Academy of Ophthalmology for additional information on eye health. And learn more about diabetes and vision concerns at the American Diabetes Association.
