Lessons from a Diabetic Eye Doctor:
How to Avoid Blindness and Get Great Eye Care

Paul Chous, M.A., O.D. Doctor of Optometry
Type 1 diabetic since 1968

Part 1:
In this section, we will consider in some detail the several different forms of “diabetic eye disease,” building upon the fundamentals discussed in previous articles and stressing the steps every diabetic can and should take to reduce the risk of eye complications. Importantly, many of these risk reduction strategies will have the added benefit of reducing the risk of all diabetes complications, both microvascular (eyes, kidneys and nerves) and macrovascular (heart, brain and large blood vessels).

When thinking about the eye complications of diabetes, most people, including most health care professionals, think of diabetic retinopathy, the process through which the eye’s light sensitive retina is damaged by chronic hyperglycemia. Indeed, diabetic retinopathy is arguably the most important example of diabetic eye disease, as it accounts for more than 22,000 cases of legal blindness each year in the United States, and more than 200,000 cases annually Worldwide. However, diabetic retinopathy, which has several different forms and stages, is itself only one of several completely distinct types of “diabetic eye disease.” Recognition and understanding of each of these particular types will help health care providers and patients alike to recognize specific eye and/or vision symptoms related to previously diagnosed diabetes and, perhaps, to suspect undetected cases of diabetes when a clinical diagnosis has yet to be made.

There are seven different “diabetic eye diseases”: diabetic cataract; glaucoma; diabetic keratopathy; diabetic optic neuropathy; diabetic cranial neuropathy; diabetic retinopathy; and retinal vascular occlusion. Each affects a different part of the eye, from the nerves that control eye movement to the nerve that connects the eye to the brain, from the front surface of the eye to its innermost internal layers. To better appreciate these various diseases, it will be helpful to conduct a “crash course” of sorts in ocular (eye) anatomy. To learn more about these diabetic eye diseases click here http://www.diabetesincontrol.com/Chous/index.shtml

It is extremely important that all diabetics understand a fundamental distinction between good eyesight and good eye health. The ability to see clearly (on an eye chart test or in the real world) is not equivalent to having healthy eyes. Many patients with serious eye disease have excellent eyesight, and the vast majority of patients who require eyeglasses or contact lenses to see clearly have healthy eyes. Just as for many patients with heart disease or cancer, patients with eye disease often have no symptoms until it is “too late.” Regular, comprehensive eye examinations by an eye care professional (optometrist or ophthalmologist) are the best way to ensure both good eyesight and good eye health.
(reprinted with the Permission of Dr. Paul Chous)

Lessons from a Diabetic Eye Doctor: How to Avoid Blindness and Get Great Eye Care
Book Description

Diabetes affects every part of the eye, not just the retina. Presenting critical information about seven different kinds of diabetic eye disease as well as important steps all diabetics must take to preserve vision, Dr. Chous clearly and comprehensively guides you through the fundamentals of good diabetes management and great eye care. Written by an eye doctor, diabetes educator and patient advocate, this book is dedicated to helping you or someone you love avoid blindness and other complications by taking charge of your diabetes
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