November 2022 Newsletter

In Celebration of 10 Years in Fostoria

Diabetic Eye Exams

Research shows significantly more people with diabetes got their critical annual dilated eye exam during the first two years following Medicaid expansion under the Affordable Care Act (ACA). However, this encouraging increase in the exam rate did not persist beyond two years. The study’s authors suggest that changes beyond expansion of insurance coverage may be necessary to tackle this leading health challenge, including a national early detection program that uses artificial intelligence and telemedicine to enable broader coverage and more public education. The Eye Centers of Northwest Ohio joins the American Academy of Ophthalmology in reiterating the importance of eye exams during the month of November, which is observed as Diabetic Eye Disease Awareness Month.

Diabetes is the leading causes of preventable blindness in the United States among adults age 20 to 74 and is the fifth most common cause of preventable blindness globally. Among the 30 million Americans with diabetes, about one-third have diabetic retinopathy, the potentially blinding complication of diabetes.

People typically don't notice changes in their vision in the disease's early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed. That’s why it’s so important that everyone with diabetes has yearly exams for early detection. But the U.S. Centers for Disease Control and Prevention consistently reports that less than two-thirds of people with diabetes undergo their recommended annual dilated ophthalmic examination. These rates are even lower among children and adolescents with diabetes, with less than half of youth with type 2 diabetes receiving an examination within six years of diagnosis.

Health officials hoped that expanding Medicaid, the state-based insurance program that covers an annual dilated eye exam for people with diabetes, would encourage more people to get their annual exams. To assess the actual impact of this policy, researchers at Harvard and Yale evaluated the rates of diabetic eye exams in states that expanded Medicaid under the ACA compared with states that did not expand Medicaid.

The researchers found that the annual exam rate increased by 6.3 percent during the first two years following expansion (2014-2015). However, the increased rate dropped to 4.1 percent at year three and to 2.3 percent at year four (2016-2017); rates similar to pre-expansion levels. Throughout the study period, expansion states had higher dilated eye examination rates compared with non-expansion states for all but these last two years. This decline in later years suggests that although health insurance did help at-risk patients receive eye exams for early detection, some patients stopped coming in after their first exams.

What Is Diabetic Eye Disease?

Diabetic eye disease is a term for several eye problems that can all result from diabetes. Diabetic eye disease includes:

Diabetic Retinopathy,
Diabetic Macular Edema,
Cataract, and
Glaucoma.

Diabetic Retinopathy

Diabetic retinopathy is when blood vessels in the retina swell, leak or close off completely. Abnormal new blood vessels can also grow on the surface of the retina.

People who have diabetes or poor blood sugar control are at risk for diabetic retinopathy. Risk also increases the longer someone has diabetes. One woman developed diabetic retinopathy after living with diabetes for 25 years.

Diabetic Macular Edema

Macular edema happens when fluid builds up on the retina and causes swelling and blurry vision. Diabetes can cause macular edema. Diabetic macular edema can lead to permanent vision loss.

Diabetes And Cataracts

Excess blood sugar from diabetes can cause cataracts. You may need cataract surgery to remove lenses that are clouded by the effects of diabetes. Maintaining good control of your blood sugar helps prevent permanent clouding of the lens and surgery.

Diabetes And Glaucoma

Glaucoma is a group of diseases that cause damage to your eye's optic nerve. This damage leads to irreversible loss of vision. Having diabetes doubles your chance of getting glaucoma.

What Other Eye Problems Are Related To Diabetes?

Diabetes can cause vision problems even if you do not have a form of diabetic eye disease.

If your blood sugar levels change quickly, it can affect the shape of your eye’s lens, causing blurry vision. Your vision goes back to normal after your blood sugar stabilizes. Have your blood sugar controlled before getting your eyeglasses prescription checked. This ensures you receive the correct prescription.