Ignorance is Not Bliss for Diabetics
By Paddy Kamen

Transitions Optical teams up with eyecare professionals to address need for education.

‘Don’t worry, be happy’ seems to be the prevalent attitude when it comes to the majority of diabetics. A new research study sponsored by Transitions Optical Inc. finds that 55 per cent of diabetics don’t bother to have regular eye exams. This is a shocking reality, given that damage to the retina caused by diabetes is the leading cause of blindness in the U.S., where one in 20 Type 1 diabetics, and one in 15 Type 2 diabetics will develop retinopathy, half of whom will become legally blind.

Diabetic retinopathy is one of the many potential complications of chronic diabetes. Retinopathy is a disorder in which the cone and rod cells of the retina are damaged when the tiny capillaries that nourish the retina become porous. The blood vessels leak blood and fluids, initiating the process of cellular damage. As new capillaries form in the injured area, vision is further reduced. Disease in these blood vessels can lead to retinal hemorrhage, retinal edema, and micro aneurysms.

Regular eye examinations are essential for diabetics and those at risk because retinal deterioration can occur independent of symptoms. But, according to the Transitions study, if identified at an early stage, eyecare professionals can help to manage the disease and prevent vision loss through treatments like retinal photocoagulation, vitreoretinal surgery and pharmacological agents. Eyewear that provides UV protection, contrast preservation and glare control can improve residual vision in diabetic retinopathy patients. More than half of individuals with diabetes and those indicating high risk of developing diabetes, and nearly half of respondents overall, noticed increased sensitivity to glare with age.

Almost two million Canadians have diabetes, and baby boomers are in the demographic (aged 40-59 years) with the highest prevalence rates, from
4-6.5 per cent. The disease affects approximately 40 per cent of individuals with Type 2 diabetes, and occurs in the majority of individuals with longstanding diabetes of over 20 years.

Transitions is playing an active role in addressing the need for education. To help apply context to the results of their survey, Transitions hosted a professional review session on June 1, 2009. Attending were one ophthalmologist, three optometrists and one optician. The group reviewed the research, discussed their perspectives on the findings and shared suggestions for what eye care professionals and the industry overall can do to help raise awareness.

Commenting on the poor showing among diabetics for regular eye exams, panel member Dr. Patrick Quaid, a Ph.D. optometrist from Guelph, Ontario, noted that the results are unfortunate, but not necessarily unexpected. “Unfortunately, it appears to be human nature to delay the eye exam, or worse forget to schedule appointments altogether, until such time as vision is affected. This underscores the importance of educating patients that they require follow up even if their vision appears to be unaffected.”

Wael Yassein agrees. The Oshawa, Ontario-based optician recognizes the important role all three professional groups can play in educating patients. “Patients often think of questions after they have left the doctor’s office and the optician should be able to answer basic questions about all eye diseases. For example, I let diabetics know that they qualify for free eye exams under our provincial health plan.”

Taking care of the vision wear needs of patients in terms of light sensitivity and night glare is another important aspect of the optician’s role with diabetic patients. “The optician’s job isn’t just about what happens in the store or clinic, it’s about what the patient needs 24 hours a day,” notes Yassein.

The Transitions study also showed that 70 percent of all boomers surveyed reported never receiving information on complications of diabetes from a medical professional. While many of these respondents were not identified as diabetic or at risk, review participants agreed that education on diabetes is still very important for this group, given that up to half of all people with diabetes are unaware they have it – and that boomers are already at higher risk.
 
Professional review group participants suggested that sharing analogies to other preventative care needs, such as oil changes for cars, can be helpful. They also suggested sharing anecdotes of what has happened to other patients who did not pursue regular care. It can be difficult for eyecare professionals to identify which patients are at risk for diabetes, unless they are taking medications for the disease or share information that points to them being at risk. Directly asking a patient if he or she is at risk for diabetes could be taken as an insult, so approaches tend to center around asking questions that relate to symptoms of the disease. These can include unusual thirst, frequent urination, weight change (gain or loss), extreme fatigue or lack of energy, blurred vision, frequent or recurring infections, slowly healing cuts and bruises and tingling or numbness in the hands.

Transitions Optical plans to use the results of the survey as part of its consumer media outreach initiative. This will include consumer advertising and a new paper for eye care professionals – Management of Diabetic Retinopathy Cases in Canadian Ophthalmic Practice: a Resource for Eye Care Professionals—to be released in October. Another paper, Healthy Sight Counseling: Diabetes and the Eye, provides recommendations for eyewear options that meet the needs of diabetic patients. To obtain these and other educational papers, call Transitions Optical customer service at 1.877.254.2590.