Study: Less than half with diabetic macular edema know vision risks

Diabetic macular edema (DME) can lead to blindness if left untreated. Yet in a new study, fewer than half of patients with this condition knew diabetes could affect their sight.

In reality, most vision loss from diabetes can be prevented.

For the study, researchers used data gathered from 2005 to 2008 through the National Health and Nutrition Examination Survey. They looked at 798 patients with type 2 diabetes. All were over age 40 and had retinal imaging done.

Of the respondents, 48 had DME. Of these patients, only 45 percent had been told by practitioners that diabetes could affect their vision.

A. Paul Chous, O.D., who specializes in diabetes eye care and education and is AOA's representative to the National Diabetes Education Program, finds the results surprising and unacceptable.

They likely reflect poor provider communication, poor patient understanding or both, Dr. Chous said.

"The uninformed patients may have, in fact, been told about their condition, but were not appropriately educated as to its meaning and the risk of vision loss," he said. "This may be especially true in patients with modest vision loss in only one eye, as the other eye compensates."

Dr. Chous also notes that the sample size of patients with DME in this study was small.

"It's likely most of the 48 patients with DME did not have severe DME requiring treatment, or else they would have been treated or referred for treatment by the doctor making the diagnosis," he said.

Optometry's role in diabetic vision health

Even with such caveats, the results can be a call for better patient education. In the United States, diabetes affects 27 million people, and 79 million more have pre-diabetes and an increased risk of disease. 

"The growth of diabetes in the U.S. makes optometric involvement all the more important," Dr. Chous said.

Optometrists are on the front lines of detection for diabetic retinopathy, DME and other conditions. Dr. Chous believes early detection for all diabetes-related vision loss is critical. 

"People with diabetes are up to 30 times more likely to suffer blindness than the general population," he noted.

In his own practice, Dr. Chous educates patients with handouts, retinal photography and a diabetic retinopathy risk calculator, among other materials. These materials show the positive effects of proper blood glucose control and disease management. 

"In reality, most vision loss from diabetes can be prevented with regular dilated eye examinations, early detection, appropriate follow-up and treatment as indicated—and patient empowerment," Dr. Chous said.

For more information see the AOA's tools and resources and no-cost supplement.

January 27, 2014

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