Questions & Answers
Q & A – Control Your Diabetes
J. Brooks Crawford, MD
PBNC Medical Advisory Committee
Q: I just was diagnosed with diabetes. When do I have to start taking care of my
eyes, and what specific steps do I need to take to preserve my vision?
A: People with newly diagnosed diabetes should have an initial exam after the diagnosis to assess the baseline condition of their visual system. The frequency of future examinations will depend on the condition of their eyes at this exam and the severity of their diabetes. It would generally be once a year after that but could vary from every few months to 2 years, depending on whether the retina is already affected or if there is coexisting eye disease such as glaucoma (more common in diabetics) or macular degeneration.
The most important steps to protect the eyes from problems associated with diabetes are:
1. Control the diabetes (maintain healthy blood sugar level)
2. Control any associated hypertension (high blood pressure)
3. Avoid smoking
Protect your Vision – Control your Diabetes!
J. Brooks Crawford, MD, emphasizes that controlling your diabetes is the primary strategy against developing diabetic retinopathy and other diabetes related eye diseases such as glaucoma and cataracts. So what can you do to protect your vision if you have diabetes? The National Eye Institute advises you to get a dilated eye exam at least once a year, and to keep “TRACK” of your diabetes:
T Take your medications as prescribed by your doctor.
R Reach and maintain a healthy weight.
A Add more physical activity to your daily routine.
C Control your ABC”s – A1C*, Blood pressure, and Cholesterol levels.
K Kick the smoking habit.
* A1C is a simple lab test that measures your average blood glucose level over the last 3 months. It is the best way to know your overall blood glucose control. Keeping TRACK of your diabetes will significantly lower your risk of developing diabetes-related vision problems.
Q & A - Cataracts
Shiu Y. Kwok, MD, PhD, PBNC Medical Advisory Committee
& Erich P. Horn, MD, PBNC Board of Directors
Q. If you already had cataract surgery and your vision gets bad again can you have it redone?
From the way the question is posted, it is reasonable to assume the cataract surgery was successful and vision was improved. But the vision later “turned bad.” The answer depends on why the vision went bad again. Diagnosis is critical to treatment. The most common problem after cataract surgery is that scar tissue can form behind the lens. Laser treatment to remove the scar tissue generally brings very good results. Cataracts do not grow back after cataract surgery, and neither does the lens. In cataract surgery the eye’s natural lens is removed and replaced by a synthetic lens. Keep in mind that deterioration of vision may be due to a separate problem altogether. For example, the poor vision may be caused by macular degeneration, advanced glaucoma or other eye diseases not related to the cataract surgery.
2. When and why would cataract surgery NOT be recommended?
When we offer cataract surgery, our purpose is to improve vision which is compromised by the cataract. But as mentioned above, if a particular patient also has other conditions attributable to the visual loss, cataract surgery will not by itself improve vision. Cataract surgery is therefore not advisable in those situations, unless it is felt that the cataract is the main contributory factor for the visual impairment. This is a judgment question to be answered by the ophthalmologist. As with any surgery, cataract surgery is not recommended unless the individual is in reasonably good health.
Q & A – Dry / Red Eyes
J. Brooks Crawford, MD
PBNC Medical Advisory Committee
Q: Sometimes my eyes feel dry, scratchy and irritated and yet I get blurred vision from watery eyes too. I am 65 years old and wonder if this is just my age?
A: You probably are suffering from insufficient tear production, the so-called dry eye syndrome.
Q: Will using eye drops to “get the red out” help cure this?
A: No. Drops to “get the red out” work by temporarily constricting the blood vessels on the surface of the eye. Over-use of them will make your eye more red and irritated. Artificial tears without a vasoconstricting agent may give temporary relief. If you use artificial tears more than 3 or 4 times a day, you should use the type that are “preservative free.” The preservatives in many eye drops can irritate the eye, especially in people who are sensitive to them.