The following article recently appeared in a number of southeastern Wisconsin publications, including 50-Plus, Boomers, HealthWisc, The Milwaukee Times, and The Milwaukee Courier.
With the burgeoning diabetes epidemic in our nation, chances are you know at least one of the more than 329,000 Wisconsinites living with the disease. Perhaps you are one of them. Perhaps you will be some day. Take note. Diabetes does more than wreak havoc with blood sugar levels. Without taking proper precautions, it can rob a person of their sight.
Richard Trivalos, 75, of Muskego, has been diabetic for more than 15 years and relies on ophthalmologist Brett Rhode, MD to help him manage his related eye problems. "When I was first diagnosed with diabetes by my primary physician, I was having some of the classic signs. I was thirsty all the time," he recalls. "When I began seeing Dr. Rhode for my eyes, it was routine at first. But, in the last few years, he has had to treat me for diabetic retinopathy."
Rhode, Head of Ophthalmology at Aurora Sinai Medical Center and a partner at Eye Care Specialists private practice, explains, "Mr. Trivalos developed what is called 'diabetic retinopathy.' What happens is that, with diabetes, high blood sugar levels can weaken blood vessels in the eye, causing them to leak blood or fluid. This causes the retina to swell and form deposits that can lead to vision loss. Blood sugar fluctuations can also promote the growth of new, fragile blood vessels on the retina, which can sometimes leak blood into the vitreous (the clear, jelly-like substance that fills the eyeball). This retinal blood vessel damage, or retinopathy, can blur vision and lead to permanent visual impairment."
Trivalos is not alone. "Of the 20+ million Americans diagnosed with diabetes, up to 45 percent have some degree of diabetic retinopathy (damage to the retina). Nearly a million have it severe enough to cause vision loss and up to 25,000 go blind each year," reports Dr. Norman Cohen, co-founder of Eye Care Specialists, an ophthalmology practice that has treated tens of thousands of diabetic patients since 1985. "For some people, when a routine vision check-up uncovers retinopathy, it's their first clue that they even have diabetes."
"Diabetic eye disease can appear as early as a year after the onset of diabetes. And, all diabetics—Type 1, Type 2, insulin-dependent or not—are at risk. And, the risk increases with the number of years you have diabetes. For example, patients with diabetes for less than five years have about a 15 percent incidence of retinopathy. This risk skyrockets, however, to 80 percent in people who are diabetic for 15 or more years," explains Dr. Robert Sucher, eye surgeon and fellow co-founder of Eye Care Specialists.
Louis Sticks, 65, of Watertown, was diagnosed with Type II diabetes at age 46. Like Trivalos, his diabetes didn't initially affect his eyes. "It crept up on me really," explains Sticks, owner of Brook Falls Organ & Piano Co. in Butler. "I'd be reading music, and notes would just seem to disappear and reappear. I would tell people I was having a 'bad eye day.' But, it began to happen a lot, and it became worrisome." Sticks went back to his general doctor who examined his eyes and told him to see an ophthalmologist. Like Trivalos, he sought out the expertise of the doctors at Eye Care Specialists.
"Unfortunately, a 'bad eye day' is a lot more serious than a 'bad hair day.' It may be that a patient's blood sugar levels are off that day, which can temporarily affect vision. Or, it could be a sign that a much greater problem is developing. That's why it's crucial for diabetics to schedule yearly dilated eye exams," advises Dr. Daniel Ferguson, an eye care specialist who sees patients from all walks of life at three offices in the Milwaukee area. "Usually there are no symptoms. However, significant retinopathy may be present and progressing even if a person's vision still appears to be good. In fact, many people don't notice a problem until the retinopathy is so far advanced that lost vision can't be restored." Ferguson explains, "Diabetic eye disease can only be diagnosed through a comprehensive eye examination. Pupil dilation (enlargement with drops) is necessary to best check the back of the eye for early signs of retinopathy before noticeable vision loss occurs." He adds, "What's most frustrating to us is that diabetes-related sight loss is often preventable with yearly exams and early intervention. But all of our expertise, lasers and treatments are of no use if patients don't come in and have their eyes regularly checked."
Trivalos and Sticks, however, have been proactive in protecting their vision for the future. Both have had laser therapy and new medication injection treatments for their condition."Although not all diabetics can have or need it, laser treatment is extremely effective in reducing the incidence of severe vision loss (in some cases by at least 50 percent) especially if started early enough," states Dr. Mark Freedman, a leading area eye surgeon and lecturer on diabetic eye disease. "In cases where laser therapy is not possible or effective, we have been very pleased with the success of new medications that can be painlessly injected directly into the eye to decrease leakage from blood vessels and decrease the growth of new abnormal vessels—thus staving off progression of the disease." He adds, "We've seen some amazing results with Avastin and Triesence, including not only stabilization of vision, but in some cases, improvement in sight. However, we must evaluate each patient's response individually to determine if and when (often every 6-12 weeks) they should receive injections."
"As Dr. Freedman said, the main goal of laser and injection treatment is to stabilize retinopathy rather than to restore lost vision," stresses Rhode. "However, Mr. Trivalos and Mr. Sticks are among those fortunate enough to have actually seen some improvement in visual acuity after their treatment. In fact, the vision in Mr. Trivalos' left eye improved from 20/100 to 20/60 in just one month." Trivalos comments, "The injection felt more like pressure than pain. It really didn't hurt. And, I have noticed improvement in my vision." The retired homebuilder enjoys putting his enhanced vision and woodworking skills to use building custom pool tables for his daughter's business.Sticks also continues his own creative pursuits despite his bout with diabetic eye disease. "I was a church organist for many years and had to back off a bit because of my eyes. But, now I enjoy singing in the choir and I fill in on the organ when they need me." When asked if he has any advice for fellow diabetics, Sticks comments, "I would tell anyone who is diagnosed with diabetes to go and see their eye doctor right away. I have told other people what I have gone through and, if they don't have a doctor, I send them to Eye Care Specialists."
For a free educational booklet on diabetes, cataracts, glaucoma, dry eyes or macular degeneration, call Eye Care Specialists' Community Education Hotline at 414-321-7035. Since 1985, Eye Care Specialists has provided comprehensive medical, surgical and laser care for virtually every eye condition to more than 121,000 southern Wisconsinites at locations in West Allis, Wauwatosa and downtown Milwaukee.
Special for our readers, Eye Care Specialists surgeons Drs. Brett Rhode & Daniel Ferguson have offered to personally respond to e-mail or telephone questions from people who do not have an eye doctor or are looking for a second opinion. Call 414-321-7035 or e-mail: email@example.com###
Diabetes is being diagnosed in huge numbers across all ages and races. Saturated fats, simple sugars, super-sized portions, bulging waistlines, and lack of exercise are some of the known culprits. Whatever the causes, the increased incidence of diabetes means a corresponding increase in health problems related to the disease, including the sight-robbing complication of "diabetic retinopathy"—the leading cause of new cases of blindness in America. Eye care specialists are fighting the battle to protect vision through education and the use of lasers and new medication injection treatments. Wisconsin Diabetes Advisory Group member and medical optometrist Dr. David Scheidt encourages patients to also take non-invasive steps of their own to prevent diabetic vision loss, including: