1. Diabetes and the Eyes Kenyon Anderson, O.D.

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

3. 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

4. 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…..

5. 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?

6. 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

7. Stages of Diabetic Retinopathy Mild Nonproliferative Diabetic Retinopathy Moderate Nonproliferative DR Severe Nonproliferative DR Proliferative DR With or without Clinically Significant Macular Edema

8. Mild Nonproliferative DR Earliest Stage “Dot/blot” hemorrhages Microanuerysms No treatment Regular dilated eye exams

9. Moderate Nonproliferative DR Lack of oxygen and nutrients Possible blockage of vessels More progressed

10. Severe Nonproliferative DR More significant damage in retina Similar vascular damage, more severe

11. Proliferative DR Ischemia, significant lack of oxygen and nutrients New blood vessel growth (neovascularization)

12. Diabetic Macular Edema Swelling of the macula May be evident at any stage of diabetic retinopathy Requires treatment Central Vision

13. 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

14. 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

15. Risk Factors Duration of diabetes Poor blood sugar control Hypertension High cholesterol Smoking Pregnancy

16. Take Home Annual Dilated Eye Examination, regardless of visual acuity Diet, healthy nutritional guidelines Exercise regularly No smoking Medical eye exams = Medical Insurance

17. THE END THANK YOU Any questions?