NOVEMBER IS AMERICAN DIABETES MONTH

At Spectrum Eyecare in Peachtree City, Dr. John Henahan considers educating diabetic patients one of his most important missions.  That is because diabetes is the single leading cause of irreversible vision loss in Americans under 70 years of age.  During this month, please visit stopdiabetes.org to learn more about this disease.  As for preserving your vision, below are Dr. Henahan’s top tips to prevent vision loss if you are diabetic.

 1)    Annual Eye Exams

Seeing well into the future is no big trick — as long as you have regular vision and eye health examinations.  There are many disorders and diseases that can have long lasting affects on your eyes if not diagnosed early.  One disease that can be detected during a thorough eye examination is diabetic eye disease. Yet, less than 50% of diabetics have an annual diabetic eye examination.  That is unfortunate, as early detection and treatment can prevent vision loss in the majority of people suffering from diabetic eye disease.  Studies have repeatedly shown that early detection of diabetic eye disease is essential for the prevention of vision loss.  Once vision loss occurs, it is unlikely that full function can be recovered.

2) Retinal Photography

Be sure that your eye examination includes a dilated eye examination and photography of the retina (the part of the eye where most vision loss in diabetes occurs). Retinal photography has been shown to detect diabetic eye disease in more people than an eye examination alone.

Note blood spots and white swollen areas (click to enlarge)

3)   Control Blood Sugar

The two main risk factors for diabetic eye disease are how long you have been diabetic and how well you control your blood sugar.  Since you cannot control how long you have been diabetic, it is imperative that you control your blood sugar. The most important measure of control is a blood test called an “A-1-C” test. This test measures how well you have controlled your blood sugar for the past 90 days or so.  “I often tell my patients that this test is the best way to know if you are winning or losing your battle with diabetes”, says Dr. Henahan. It is critical to have this test done by your doctor as directed (typically every three months).  Also you need to know your doctor’s goal for your score (typically in the 6.0-7.0 range).  If you don’t know your score, you need to find out.

Dr. Henahan and Spectrum Eyecare are emphasizing the importance of annual dilated eye examinations during American Diabetes Month in November.  As a diabetic, or a person at risk, seeing your optometrist is as important as visiting your physician regularly and following instructions about proper diet, exercise, and medication.

Remember, if you are diabetic your medical insurance will cover an eye examination, so you do not need vision insurance to have an exam (you may still have a deductible or co-pay, check with your insurance company).

Schedule an annual eye examination today if it has been more than a year or if your blood sugar control has been deteriorating. Dr. Henahan is a resident of Peachtree City and founder of Spectrum Eyecare.  You may reach his office at 770-487-0667 or on the web at SpecEye.com.

The Los Angeles Times (8/11, Maugh) reports, “Nearly three in 10 Americans with diabetes over the age of 40 suffer from vision impairment caused by diabetic retinopathy, and about 4.4% have a form of the condition so severe it threatens their eyesight,” according to a study published in the August 11 issue of the Journal of the American Medical Association.

HealthDay (8/10, Gordon) reported that “the news wasn’t all bad, however. The findings suggest that good control of blood sugar, blood pressure, and cholesterol can go a long way toward preventing or slowing diabetic eye disease.” For the study, CDC researchers “reviewed data from the National Health and Nutrition Examination Survey from 2005 to 2008, which included nearly 7,000 people over age 40,” 1,006 of whom had diabetes.

Focusing on specific gender and ethnic/racial demographics, WebMD (8/10, Woznicki) reported that “31.6% men and 25.7% of women over age 40 who have diabetes are estimated to have diabetic retinopathy,” while “38.8% of non-Hispanic blacks were estimated to have diabetic retinopathy, 34% of Mexican-Americans, and 26.4% of non-Hispanic whites.” Interestingly, “age was not a major factor among the study group.”

“Independent risk factors for diabetic retinopathy included male sex, higher hemoglobin A1c level, longer duration of diabetes, and higher systolic blood pressure, with respective odds ratios of 2.07, 1.45, 1.06 per year of duration, and 1.03 per millimeter of mercury,” MedPage Today (8/10, Smith) reported. Reuters (8/11, Peeples) also covers the story.

While taking all possible steps to prevent diabetic retinopathy, an annual eye exam with dilated pupils is essential according to Dr. John Henahan of Spectrum Eyecare in Peachtree City, GA.  ”At Spectrum Eyecare, we take finding diabetic retinopathy very seriously.  Early diagnosis greatly reduces the chance that vision loss will occur, so we dilate the eyes and take high resolution photographs of the retina to make sure we don’t miss even the slightest changes from diabetes.”  If you or a loved one are diabetic and have not had an eye exam in the past year, then please contact us or your local eye doctor for an exam.

May is Healthy Vision Month, according to the National Eye Institute. Since Diabetes is the number one cause of vision loss in Americans under age 65, an annual eye exam for diabetics is critical according to The Tennessean (5/9).

In an op-ed Mary Gaines, RN, director of the Diabetes Centers at Baptist Hospital and Middle Tennessee Medical Center, wrote, “It’s a safe bet that diabetes is likely the leading cause of blindness across the Volunteer State — and an important reason to call attention to Healthy Vision Month in May,”.

Gaines pointed out that May is the “time for health professionals and patients to pay particular attention to the importance of ‘eye health’ and the need for an annual dilated eye examination.” In Tennessee alone, “an estimated 21 percent of adults living with diabetes have had their eyes affected by the disease,” and as a result may suffer from glaucoma, cataracts, and diabetic retinopathy.

Similarly, in Georgia, many patients with diabetes are not getting an annual eye exam with retinal photography to ensure that they are safe from diabetic retinopathy, according to John L Henahan, OD, FAAO optometrist at Spectrum Eyecare in Peachtree City.  ”Only be having a complete medical eye exam with pupil dilation and retinal photography can your doctor ensure that you do not have diabetic retinopathy.”, continues Dr. Henahan.

In fact, many eye doctors do not even have a retinal camera, so be sure to inquire when making an appointment for your annual exam.  At Spectrum Eyecare, Dr. Henahan works closely with primary care physicians to coordinate a patient’s care.  ”We email photos of your retina to your doctor so they can see for themselves the status of your retinal health.”

Many patients avoid seeing the eye doctor out of concern for the cost, especially if they do not have vision insurance.  But according to Dr. Henahan patients with diabetes can use their medical insurance for their eye exam.  ”Many patients do not understand the difference between vision insurance and medical insurance.  They assume anything to do with the eyes requires vision insurance, which simply is not the case.  If you have a medical eye problem or diabetes, the exam and testing (such as retinal photography) can be processed through your medical insurance such as Blue Cross or Medicare.”

Early diagnosis of diabetic retinopathy is so important that Dr. Henahan works closely with his patients to ensure that they can get the needed photographs, even if they do not have medical insurance.  ”We don’t want anyone to lose vision because of lack of insurance, we provide discounts and other assistance to help those without insurance.”  If you or a loved one has diabetes, high blood pressure or have not had an eye exam recently, contact Spectrum Eyecare to learn about preventing diabetic retinopathy and to schedule an eye exam.

Among the leading causes of vision loss and blindness are diabetes, high blood pressure and high cholesterol, according to Dr. John Henahan, optometrist at Spectrum Eyecare in Peachtree City.  ”As the incidence of these diseases is climbing, so too are ocular complications, including cataracts, diabetic retinopathy and other retinal problems.”, according to Dr. Henahan.

In fact, ABC World News (4/26, story 7, 1:20, Sawyer) reported that “almost half of American adults, 45% of us, now have high blood pressure, high cholesterol, or diabetes,” according to researchers from the national Centers for Disease Control and Prevention.

The Los Angeles Times (4/27, Maugh) reports that “one in eight Americans has at least two of the conditions and one in 33 has all three, sharply increasing their risk.” These “data come from the ongoing National Health and Nutrition Examination Survey.” While “researchers should be able to use the new data to plan interventions, ‘the main thing here is for people to be aware that they have these conditions and know that lifestyle modifications and medications can control them and reduce their risk for cardiovascular disease,’ said epidemiologist Cheryl D. Fryar of the CDC’s National Center for Health Statistics, one of the study’s authors.”

WebMD (4/26, Woznicki) reported that “the study shows that about 8% of adults have undiagnosed high blood pressure, 8% have undiagnosed high cholesterol, and 3% of have undiagnosed diabetes.”

HealthDay (4/26, Edelson) reported that “blacks had a particularly high incidence of hypertension, 42.5 percent, compared to 29.1 percent of non-Hispanic whites and 26.1 percent of Mexican-Americans.” The report indicated that “high blood cholesterol was more common among non-Hispanic whites (26.9 percent) than among blacks (21.5 percent) and Mexican-Americans (21.8 percent), while diabetes was more common among blacks (14.6 percent) and Mexican-Americans (15.3 percent) than among non-Hispanic whites (8.3 percent).”

According to Dr. Henahan, “If you or someone you care about has one of these conditions, it is critical to get annual eye exams with your pupils dilated, even if you have perfect vision.  It’s less about eyeglasses for these patients than it is about the medical health of the eyes.”

At Spectrum Eyecare, all diabetics receive retinal photos to ensure that no diabetic retinopathy is present.  That helps preserve vision by finding problems early so treatment can prevent vision loss.

Many patients do not understand that in most cases they can have an eye exam covered by their medical insurance if they have one of these medical conditions.  ”You do not need vision insurance to have an eye exam if you are diabetic, hypertensive or have high cholesterol”, reports Dr. Henahan. Although you may have a copay or deductible to meet, the exam can be filed through your medical insurance.

If it has been more than one year since your last eye exam, or if you are newly diagnosed with one or more of these conditions, contact us to schedule your medical eye exam.  At Spectrum Eyecare, we schedule just two full eye exams per hour so we can be thorough in evaluating the total health of your eyes.

After all, you only have one set of eyes.

Type 1 Diabetes is an autoimmune disease whereby a person’s own immune system attacks the cells that produce insulin, destroying them.  When insulin is not produced, the person cannot control their blood sugar and it climbs ever higher without use of synthetic insulin from shots or a pump. In many patients with diabetes, vision loss and even blindness can result.

HealthDay (4/8, Gordon) reported that, according to a study published online April 8 in the journal Immunity, researchers from the University of Calgary “have successfully reversed type 1 diabetes in mice using a new vaccine technology that appears to solely target the immune system cells responsible for the disease.”

By “using a ‘nanotechnology-based’ vaccine, the researchers were able to boost the effects of the weaker immune cells, which allowed them to stop the damaging immune cells from attacking.” So, “instead of directly attacking the stronger cells, the autoregulatory T cells turn off the signal that tells the stronger immune cells to attack, effectively stopping the destruction of the beta cells that allow the body to produce it’s own insulin.”

According to Reuters (4/9, Steenhuysen), the study’s findings may help researchers find new ways how to manage other autoimmune conditions, such as rheumatoid arthritis.

Diabetes is the number one cause of vision loss in children and adults under age 65, according to optometrist Dr. John Henahan.  Therefore, any movement toward a cure for diabetes represents reason for celebration for health care workers and patients alike.

At Spectrum Eyecare in Peachtree City, Dr Henahan reports that all patients are screened for diabetes (and high blood pressure) during their annual eye exam.  Any patients with diabetes receive special additional testing during their exam, including high quality retinal photography to look for signs of this condition.

In diabetic retinopathy, the blood vessels in the retina (which is similar to the film in a camera), begin to bleed and leak.  As blood and other fluid spill into the retina, the fluid is absorbed causing the retina to swell. Just as a swollen ankle does not function properly, a swollen retina does not function properly.  However, using the analogy of the ankle swelling, as the swelling there goes down, the ankle function returns to normal.  However, in the retina, as the swelling goes down, the retina never functions normally again.  A malfunctioning retina means blurred vision….permanantly.

That reiterates the importance of regular eye exams in patients with diabetes.  It is imperative to catch problems early and to use appropriate treatments to seal off leaking blood vessels BEFORE vision loss occurs.

If you or a loved one has diabetes, either type 1 or type 2 and you have not had a complete eye exam with eye health assessment in the past year, please contact us.  We would be glad to see you and we accept almost all medical insurance plans.  As an aside, when you are diabetic, you do not need a vision plan in order to have an eye examination.  We can file the exam through your medical insurance (co-pays and deductibles still apply, however).

I see great, why should I have an eye exam?

Even if you have perfect vision, most organizations, like the American Optometric Association feel that an adult should have an eye exam at least every 3 years.  Once you reach your 40’s exams are recommended a minimum of every two years.  Those 50 years of age or older should have an eye exam annually, as should people who wear corrective lenses and/or have a family history of eye disease.  Diabetics must have an exam with dilated pupils and special photographs annually (see below for more on diabetes and the eye).

The reason that even those of us with perfect vision should still have periodic eye exams is that many eye diseases have no symptoms early in their course.

Glaucoma, for example, is often called the “sneak thief of sight” because millions are suffering from this condition with no symptoms.  It is not until one has lost 80% or more of their vision that symptoms develop.  Unfortunately, any vision you have lost cannot be recovered.  That makes early diagnosis essential in the treatment of this disease.

Other conditions like Macular Degeneration (AMD) can sometimes be prevented or at least delayed. Often the precursor to this condition can be seen 20 years before AMD begins to affect vision.  With appropriate nutritional therapy, research shows that we can reduce the likelihood of a person developing AMD by up to 30% or more.

I have diabetes, what should I do to protect my eyes?

Diabetes is the number one cause of vision loss in Americans under age 65, and number 2 across all ages groups.  While most people think of diabetes as a blood sugar disease, in the eye we are concerned about changes to blood vessels that can result in hemorrhaging (bleeding) inside the eye.  This results in damage to the retina (which can be thought of as similar to the film in a camera).  This damage can result in permanently blurred vision or even total blindness if left untreated.  Early diagnosis and treatment can help preserve good vision for life.  Annual eye exams with special photographs of the retina are imperative in preserving sight for people with diabetes.

I’m in my 40’s why can’t I see up close anymore?

We all lose the ability to focus up close.  This process begins in our twenties, and typically becomes a noticeable problem in our early to mid 40’s.  This loss of focusing, called presbyopia, diminishes our ability to see clearly up close through our distance prescription. Presbyopia is a natural process, it is also a progressive process, so we tend to have greater and greater difficulty with near tasks as we move through our 40’s and into our early 50’s.  By our early to mid-50’s, the progression stops, but we never regain our ability to focus up close.

This often means a transition to bifocal glasses (often called progressive lenses) or necessitates the need for reading glasses over our contact lenses.  The good news is that with the new digitally surfaced, HD style progressive lenses, it is easier than ever to make a successful transition to multifocal glasses.  At Spectrum Eyecare, we are even having good success with people who were previously unable to use this type of eyeglasses lens.

I wear contacts and replace them online, why should I bother with an annual exam?

Contact lenses (CL) are a prescription device that when cared for appropriately are very safe.

However, as we age our eyes change, often requiring a change in the type of contact lens worn, solutions used or the replacement schedule of the lenses.  That is why all contact lens prescriptions have an expiration date.  Since CL use increases the risk of dry eye, abnormal blood vessel growth and serious eye infections it is critical to have regular, annual checks of your eyes and contacts.  This is true regardless of your age.  However, our eyes become less resilient as we age requiring even greater care in monitoring the health of our eyes as we age.

At many leading practices, including Spectrum Eyecare, it is understood that you can get your contacts from many sources, so CL’s are priced very competitively with mail order and big box retailers.  The important thing is to have an annual exam and to replace your contacts as advised by your eye doctor.

Is it safe to sleep in my contacts?

Sleeping in contact lenses is the single greatest cause of complications among those who wear lenses.  Even in the safest materials, contact lens over-wear causes at least a tenfold increase in eye infection and other dangerous complications.  Teaching and reinforcing the dangers of contact lens over-wear is one of Dr. Henahan’s top priorities.

What type of contact lens is best for me?

For most, soft disposable lenses represent the best balance of comfort, easy care, clear vision and safety.  For some people, disposable lenses are not an option due to the nature of their prescription, but other lens options do exist which allow us to fit almost any child in contacts. Advances in bifocal contact lens technology have been slow, so most people struggle to succeed with this type of lens, despite what the TV commercials want you to believe.

What about LASIK?

LASIK eye surgery is an excellent option for many people with glasses or contacts who wish to eliminate their dependence on glasses or contacts.  However, one must be at least 18 years of age to undergo LASIK.  Furthermore, it is important that the prescription is not changing.

It is also important to understand that LASIK does nothing to prevent the loss of focusing capability that afflicts those of us in our 40’s.

NEXT MONTH:  Eye FAQ’s for Seniors

Dr. John Henahan is a fellowship trained doctor of optometry practicing and living right here in Peachtree City with his wife and two sons.  You may call his office at (770) 487-0667 or visit him on the web at www.speceye.com.

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