Diabetes and the Eyes

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Diabetes and the Eyes

• Kenyon Anderson, O.D.

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Blindness Risk

• Diabetic eye disease, caused by diabetes, is a
  leading cause of blindness and vision loss.
• -Prevent Blindness America

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Diabetic Eye Disease

• Diabetic Retinopathy
• Damage to blood vessels in retina
• Cataracts
• Clouding of the lens in the eye,
• more likely to develop
• earlier with diabetes
• Glaucoma
• Damage to nerves and optic nerve causing vision
  loss nearly twice as likely to develop with
  diabetes
• -National Eye Institute

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Diabetic Eye Disease

• MEDICAL condition
• Eye health examinations, treatment, progression
  monitoring are covered by
• MEDICAL INSURANCE
• Thus can be billed to Medicare/Medicaid, Blue
  Cross, Aetna, Regence.etc..

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Diabetic Retinopathy (DR)

• What is diabetic retinopathy?
• What are the stages of damage?
• What is the treatment?
• What are the risk factors?
• What should I do?

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What is Diabetic Retinopathy?

• Damage to the small blood vessels in the retina.
• Weakening of the
• blood-retina barrier
• causing leakage,
• thickening, swelling,
• ischemia (lack of oxygen),
• and other damage

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Stages of Diabetic Retinopathy

• Mild Nonproliferative Diabetic Retinopathy
• Moderate Nonproliferative DR
• Severe Nonproliferative DR
• Proliferative DR
• With or without Clinically Significant Macular
  Edema

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Mild Nonproliferative DR

• Earliest Stage
• Dot/blot hemorrhages
• Microanuerysms
• No treatment
• Regular dilated eye exams

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Moderate Nonproliferative DR

• Lack of oxygen and nutrients
• Possible blockage of vessels
• More progressed

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Severe Nonproliferative DR

• More significant damage in retina
• Similar vascular damage, more severe

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Proliferative DR

• Ischemia, significant lack of oxygen and
  nutrients
• New blood vessel growth (neovascularization)

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Diabetic Macular Edema

• Swelling of the macula
• May be evident at any stage of diabetic
  retinopathy
• Requires treatment
• Central Vision

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Treatment

• Laser treatment
• Focal laser treatment specific spots of laser
• PRP Panretinal Photocoagulation scattered
  laser
• Laser to retina that causes scarring
• Reduces demand for oxygen to retina

See Me Now?
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Treatment continued

• Vitrectomy exchange of fluid in vitreous
• Removes blood from vitreous
• Injections
• Anti-VEGF Injections Vasoendothelial Growth
  Factor
• Causes new blood vessel growth to stop and even
  some reversal.
• Steroid Injections Occasionally used for edema

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Risk Factors

• Duration of diabetes
• Poor blood sugar control
• Hypertension
• High cholesterol
• Smoking
• Pregnancy

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Take Home

• Annual Dilated Eye Examination, regardless of
  visual acuity
• Diet, healthy nutritional guidelines
• Exercise regularly
• No smoking
• Medical eye exams Medical Insurance

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THE ENDTHANK YOUAny questions?