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Linley's Story: Why Having a Diabetic Eye Exam is Crucial

Being diagnosed with diabetes can be a tough pill to swallow. An important first step is understanding the difference between the two types of diabetes: type 1, also known as insulin-dependent diabetes; and type 2, which occurs when the body can’t produce enough insulin or resists insulin.

The exact cause of type 1 diabetes is unknown; however, the body’s immune system plays a huge role. Type 2 diabetes, which affects approximately 95% of patients living with diabetes, is caused by genetic and lifestyle factors like excess weight and inactivity.

There are currently 415 million adults living with diabetes, putting them at risk for life-altering complications—one of which is vision loss due to diabetic retinopathy.1 Diabetic retinopathy is the most common cause of vision loss among people with diabetes and the most common cause of blindness among working-age adults.2

To combat the diabetes epidemic, it is important to continue to educate, inspire and raise awareness of the importance of managing diabetes appropriately, especially when it comes to annual eye exams

Linley Champion was 8 years old when she was diagnosed with Type 1 diabetes, and 25 years old when she was diagnosed with diabetic retinopathy. She currently resides in Mount Pleasant Mills, Pennsylvania, with her husband, Jonathan, and their son, Connor. For her entire life, she was told her eyes and retinas looked great until a routine diabetic eye exam in 2015 where eye specialists found advanced stage retinopathy. “My whole life doctors would tell me that you could not even tell I had diabetes by looking at my eyes alone, then I was diagnosed with proliferative retinopathy with partial retinal detachments” says Linley.

Over time, high blood sugar levels from diabetes affect the tiny blood vessels in the tissue in the back of the eye called the retina. Diabetic retinopathy can be categorized as:3

  • Non-proliferative diabetic retinopathy: The blood vessels in the retina leak and swell.
  • Proliferative diabetic retinopathy: New blood vessels grow in the retina and may leak and bleed. A vitreous hemorrhage is bleeding into the thick fluid, called the vitreous gel, that fills the center of the eye. Having blood in the vitreous gel can keep light from reaching the retina. If the bleeding is severe, some patients may face vision loss.
  • End stage diabetic retinopathy: There may be significant or total vision loss and retinal detachment.

All her life, she didn’t experience symptoms of vision changes, except needing an updated prescription for her glasses. “Luckily, even with having a diagnosis of diabetic retinopathy, I did not need treatment for it until July 6, 2018, when I started to receive laser treatment in both of my eyes to prevent hemorrhages,” says Linley.

 

Occasionally, Linley will experience temporary vision loss when she gets bleeds from the vitreous hemorrhages. To treat the hemorrhages, she receives injections of Avastin®, a drug used to treat wet age-related macular degeneration (AMD).4 It is also used to treat diabetic eye disease and helps block the growth of abnormal blood vessels in the back of the eye. However, it is not always effective long-term. Recently, Linley was scheduled for surgery in her right eye from a vitreous hemorrhage that would not resolve with multiple injections.

Linley’s visual acuity was 20/1600 but one week after surgery her visual acuity had improved to 20/70. A month after surgery, she’s improved to 20/30, but is currently developing a cataract. On top of that, her left eye has proliferative diabetic retinopathy with retinal detachment. Her ophthalmologists are being proactive with the laser therapy to prevent hemorrhages and scarring, but if scarring continues to pull at the retina, she’ll need a vitrectomy. Linley is lucky she received the care she needed, or she could’ve been blind by now.

An Advocate for Early Detection in Primary Care

Even though Linley was proactive with her annual diabetic eye exams all her life, she knows that most people aren’t diligent with their annual eye exams. “I think the public is naïve about eye health and are scared to go to the eye doctor,” says Linley. “If the public, especially patients living with diabetes, were educated on the risks of retinopathy and the detriment to their vision, they may be more open to ensuring their eye health and vision,” Linley continues.

Linley has the chance to educate the public with her full-time job as a Medical Assistant in Mifflinburg, PA. As a Medical Assistant, she assists patients with a variety of health conditions, one being the management of diabetes. A couple of months ago, the clinic Linley works at implemented the Welch Allyn® RetinaVue® Care Delivery Model from Hillrom™ to bring diabetic retinal exams to primary care. “I think having the technology of a retinal camera that does not require dilation in a primary care office is a big step forward in the health of the patient,” says Linley.

As someone living with diabetic retinopathy, Linley believes the addition of the RetinaVue care delivery model is an invaluable asset to their practice. “I think having diabetic eye exams in the primary care physician’s office is crucial,” says Linley. She continues, “As a primary care office, patients only come to us once in a blue moon and refuse to see specialists or have their eyes dilated. The fact that we can check a patient's eye health in a 15-minute window during a regular visit is incredible.”

When it comes to giving advice to other patients living with diabetes, Linley offers, “Be diligent about your eye exams. I know it is a scary thing to do and no one likes to have the exams done, but is it really worth losing your vision due to fear?”

References

1. National Eye Institute. Eye Disease Statistics. March 2014. https://nei.nih.gov/sites/default/files/nei-pdfs/NEI_Eye_Disease_Statistics_Factsheet_2014_V10.pdf Accessed June 29, 2019.

2. Centers for Disease Control and Prevention. VHI. 2015. www.cdc.gov/visionhealth/basics/ced/. Accessed March 1, 2017.

3. Torpy, J. M., MD, & Glass, R. M., MD. (2009, August 22). Retinopathy. Retrieved June 1, 2019, from https://jamanetwork.com/journals/jama/fullarticle/208559

4. American Academy of Ophthalmology. What is Avastin? Feb 2019. https://www.aao.org/eye-health/drugs/avastin Accessed July 1, 2019.