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NEW YORK, Mar 06 (Reuters Health) - More than one third of people with diabetes do not get the medical care they need to protect themselves from losing their sight, according to results of a new study.
The findings underscore the need for diabetics and their doctors to be better educated about the potential damage diabetes can do to their eyes, and about the ways the damage can be prevented, according to Dr. George Blankenship, president of the American Academy of Ophthalmology.
The high blood sugar levels that are associated with diabetes can damage the blood vessels in the retina, the light-sensing region at the back of the eye. The disease that results from this degeneration, called diabetic retinopathy, leaves 8,000 people blind each year in the United States alone.
The early signs of diabetic retinopathy can be observed with a dilated eye exam, in which the pupil is widened with eyedrops so the retina can be seen clearly, the researchers explain in the March issue of Ophthalmology.
"Without dilating the eye, it's like looking inside a room through a keyhole instead of an open door," Blankenship said in a statement.
But in a survey of 2,308 patients with diabetes, Dr. Elinor R. Schoenfeld and her colleagues from the University Medical Center at Stony Brook in New York found 35% had not had a dilated eye exam in the past year. Within this group, one-third had had an eye exam in which the pupil was not dilated.
"This suggests a missed opportunity to supply comprehensive vision care to persons with diabetes and highlights a potential weakness in the current healthcare system," the authors note.
People with type 1 diabetes, which can cause more severe vision loss, were more likely to stick to eye care guidelines, the investigators found. Older patients and those who had received formal diabetes education programs were also more likely to receive annual dilated eye exams.
People who did not follow the guidelines also were more likely to have seen an optometrist for eye care rather than an ophthalmologist. Among those who followed the guidelines, 86% had seen an ophthalmologist for their last eye exam, while 10% had seen an optometrist.
SOURCE: Ophthalmology 2001;108:563-571.
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