Category: Eye conditions

Diabetic Eye Disease

Too many Australians have closed their eyes to diabetic eye disease, the leading cause of blindness among our working-age population, a new study has revealed.

A YouGov poll conducted early last year of 1,049 Australians commissioned by Macular Disease Foundation Australia (MDFA) discovered that only 29% of Australians aged 50 to 70 have heard of diabetic retinopathy (DR), while only 26% are aware of diabetic macular oedema (DMO), a complication of DR that threatens the central vision.

Although 82% identified the eyes as a body part that diabetes can affect – higher than feet (74%), kidneys (68%), and even the heart (53%) – the lack of awareness of what these conditions are called means many people who are at risk remain in the dark about these sight-threatening complications.

Macula Month

MDFA commissioned this study to mark ‘Macula Month’, an annual awareness campaign each May, urging those at-risk to visit their optometrist for a comprehensive eye exam – including a check of the macula.

Age-related macular degeneration (AMD) and diabetic eye disease (DED) are the most common conditions that threaten the macula and detailed central vision.

Diabetic retinopathy is the most common diabetic eye disease and the top cause of blindness in working-age Australians, affecting between 300,000 and 400,000 people.

MDFA CEO Dee Hopkins is concerned that most people cannot even name the disease.

“Diabetic retinopathy claims the eyesight of more working-age Australians than any other eye condition, yet less than 30% of people know its name,” Ms Hopkins says.

“But we do know that early action can save sight. It’s crucial that everyone over 50 – and everyone diagnosed with diabetes – has regular eye checks with their eye health professional to detect any changes to the eye early.”

60 seconds Could Save Your Sight

This year’s Macula Month campaign will promote Check My Macula a short 60 second online quiz that reveals your individual risk factors for AMD and diabetic eye disease. It then helps you make an appointment with your nearest optometrist or schedule a reminder to have an eye exam in the future.

Everyone with diabetes is at risk of developing diabetic retinopathy, and the longer a person has diabetes, the greater the likelihood of the disease.

Diabetic Retinopathy Numbers Surge

Around 1.7 million Australians live with diabetes – a figure expected to climb past two million by 2025, driving a surge in diabetic eye disease.

Almost everyone with type 1 diabetes and more than 60% of people with type 2 diabetes will develop some form of diabetic retinopathy within 20 years of diagnosis. One in three people over the age of 50 with diabetes has the condition.

MDFA Ambassador and 2020 Australian of the Year, Adelaide ophthalmologist Dr James Muecke AM, says people with diabetes can take active steps to reverse their risk of vision loss.

“Diabetic retinopathy is the only reversible macular condition,” Dr Muecke says.

“If you control your diabetes, or if you are able to put your type 2 diabetes into remission, you can turn this blinding disease around. We want people to not only understand the name of the disease –we want everyone to take action to avoid its devastating outcome.

“This is easily done through regular eye examinations and managing your diabetes. When the disease is picked up early, you can make lifestyle changes and access good treatments that maintain sight and prevent severe vision loss,” he says.

Book an eye test with your local Eyecare Plus optometrist this Macula Month to have a comprehensive eye test and to check your macula.

Diabetes is regarded as the biggest health epidemic of the modern era.

More than 20 years ago, in 1994, the Center for Disease Control and Prevention’s declared that diabetes had reached epidemic proportions. Get the latest research information from CDC here.

They reported then that it should be considered a major public health problem. Now, more than 20 years later, diabetes is raging out of control with the incidence of type 2 Diabetes more than tripling in that time.

Tragic Experience

In Australia, our First Nation People are at the greatest risk as they are “four times more likely to develop type 2 diabetes and much more likely to develop serious diabetes-related complications. The gap in health outcomes for indigenous Australians is greatest in diabetes,” Professor Greg Johnson, CEO Diabetes Australia.

Wiradjuri woman Dr Tamara Power, member of the Congress of Aboriginal and Torres Strait Island Nurses and Midwives working at the University of Technology Sydney, is one of Australia’s leading First Nations nurse academics.

Her experience with diabetes has been tragic.

“A pregnant cousin of mine, who lives with type 2 diabetes, gave birth to a full-term, stillborn baby and that was partly due to complications from high blood glucose levels during pregnancy,” Dr Power said.

“I have many family members and friends who’ve been diagnosed with diabetes and are living with severe complications like cardiac and renal disease. As a First Nations person you generally know a lot of people with diabetes, that’s the reality of the diabetes epidemic.”

Type 2 diabetes: Leading Cause of Blindness

Eye surgeon and Australian of the Year, Dr. James Muecke, blames poor dietary guidelines which recommend low fat, high carb diets, as key reasons for Australia’s obesity problem – which effects 67% of Australians – and can lead to type 2 diabetes.

If obesity is eradicated we can reduce the number of people who get type 2 diabetes by over 40%.

Type 2 diabetes is the leading cause of blindness in the world.

Diabetic Retinopathy

A complication of diabetes is diabetic retinopathy, the most widespread form of diabetic eye disease which can lead to vision loss. It is estimated that between 25 to 35% of people who have diabetes suffer from some form of diabetic retinopathy.

Diabetic retinopathy is an insidious disease. High sugar levels cause damage to the blood vessels in the retina which, over time, leads to vision loss.

Detection

There may be no obvious symptoms in the early stages of the disease.

The only way you can find out if you have diabetic retinopathy is from a comprehensive eye examination. It is a simple test where the optometrist dilates your pupils in order to see details inside your eyes.

Diabetic retinopathy symptoms include:

• Blurred, distorted or patchy vision (that cannot be corrected with prescription glasses)
• Problems with balance, reading, watching television, and recognising people
• Being overly sensitive to glare
• Difficulty seeing at night

Early detection of diabetic retinopathy is critical in order for the disease to be treated. By doing this you can reduce the incidence of severe vision loss by 95 percent.

Diabetes can cause serious health problems. It is important that people who live with diabetes see their local Eyecare Plus optometrist every year for a comprehensive eye test so that diabetic retinopathy can be identified and treated early.

World Diabetes Day is celebrated on 14 November each year. This year, WDD honours the role of nurses who work with people living with diabetes.

Around the world nurses account for more than half of the health workforce. People with diabetes benefit enormously from the education and support they receive from nurses and other health care workers, including optometrists, in managing the impact of this debilitating disease.

Cost of Diabetes

In Australia, it is estimated that 1.8 million people live with diabetes, with 1.3 million diagnosed and an estimated 500,000 undiagnosed with type 2 diabetes.

Every five minutes in Australia someone is diagnosed with diabetes, and a staggering 25 per cent of adults over the age of 25 are living with either diabetes or pre-diabetes.

The disease accounts for more than 10 per cent of all Australian deaths, making it the seventh most common cause of death by disease in Australia.

Enough is Enough

Dr. James Muecke, Australian of the Year and ophthalmologist has declared war on diabetes.

This deadly disease is now the leading cause of blindness in Australian adults.

Dr. Muecke has had enough.

Every year, Dr. Muecke sees an increasing number of patients with eye disease due to diabetes.

It is upsetting to see so many people suffering from the disease particularly as “type 2 diabetes is a preventable, dietary disease,” he says.

“We should not be seeing these blinding, maiming and deadly consequences at all. It’s time to put a stop to it.”

Sugar is Toxic

To reduce the impact of diabetes, Dr. Muecke says we need to go back to the root cause of the disease to “challenge our perception of sugar, our relationship with sugar and the impact it has on the development of diabetes. I want to encourage hard hitting strategies to build greater awareness of the detrimental role sugar plays in our society.”

“Sugar is as toxic and addictive as nicotine.”

By reducing our consumption of “sugar, refined carbohydrates, and highly processed products containing these substances (we) can prevent type 2 diabetes. It’s proven and powerful.”

Through diet and early detection of diabetic eye disease, loss of vision from diabetes can be prevented. Sadly, once vision has been lost it cannot be reversed.

Early detection, by having a regular eye examination is the best way to identify problems before they get worse, and to ensure early treatment.

Diabetes causes far too many Australians to lose their sight each year, but this can be avoided by cutting out sugar from your diet and by having regular eye tests.

Surprisingly, Dr Muecke says that of the 1.8 million people in Australia who have any type of diabetes, “less than half are having their regular eye checks, which is why it’s become such a major cause of blindness in our society.”

If you have diabetes, to avoid diabetic retinopathy, it is important to be proactive about booking an annual appointment to see your local Eyecare Plus Optometrists.

With no single treatment regime, dry eye disease, is difficult to treat creating frustration for both optometrists and patients.

Early recognition of the symptoms of dry eye disease are important so do not let the discomforting symptoms continue until they become painful and debilitating.

 We speak with two Eyecare Plus optometrists, Glenn Vessey and Denise Lee, who discuss the treatment process of dry eye disease.

Often underdiagnosed, dry eye is quite a common eye condition. Many people who have the dry eye symptoms are often not aware that they have them. Studies show that the prevalence of dry eye increases with age, occurring in up to 30% of elderly people.

The Treatment Processes

Glen Vessey, an optometrist for more than 30 years, has been particularly focussed on the treatment of dry eye disease since 2013.

“The equipment and technology we have to diagnose and treat dry eye has improved markedly over the last five to10 years… and we are steadily finding new ways to improve its diagnosis and management.

“It is essential to accurately diagnose the condition. Correct classification of the type of dry eye is equally important,” says Glenn.

During the eye examination, your optometrist will look for signs of the disease and ask you questions about their symptoms, including grading their symptoms.

“Once the optometrist accurately diagnoses and classifies the condition, the next step is to determine the most suitable treatment regimen for each patient,” says Glenn.

This leads to a more detailed discussion about dry eye disease and prescribed management.

Optometrist Denise Lee says that “mild cases of dry eye disease are prescribed lubricating eyedrops, whereas moderate to severe cases are invited to return for further testing to ascertain what other management and treatment options should be done.”

Treatment options include “a variety of medications (both prescribed and over the counter), Intense Regulated Pulse Light (IRPL), Blephasteam, heat compresses on the eyes, expression of the meibomian glands and natural oral supplements to improve tear production,” says Glenn.

“As a chronic eye condition,” Denise points out that it is important for patients to be educated, specifically, about “how to slow down its progression”.

Dry eye can become “debilitating for some, and difficult to manage in the advanced stage,” she says.

Treatment Improvements

In the past, management for dry eye involved lubricating drops, gels, and ointments, as well as bandage contact lenses and punctal plugs. Glenn Vessey states that, “if we diagnosed someone with dry eye we simply treated the condition by giving the patient additional (artificial) tears, which only treated dry eye symptoms, not the cause of the dry eye (the tear glands not producing enough tears).”

Now there are many more treatment options for dry eye.

“Now we identify those patients who would benefit from unblocking, stimulating, and rejuvenating the tear glands; reversing the process by which the glands become blocked, stop producing tears, atrophy and eventually die off. This not only provides improvement in the dry eye symptoms but reverses the deterioration of the disease over time.”

Denise Lee says that, “modern day management encompasses a myriad of options depending on the type and severity of dry eye disease”.

Treatment options today include “meibomian gland expression, intense pulse light, scleral contact lenses, amniotic membranes and drops, blood serum drops, and new formula eyedrops that target inflammation, infection, and immune suppression.

As well as these, Denise Lee uses “LipiFlow and Rexon-Eye dry eye treatments”. LipiFlow is an automated thermal heating massaging system and Rexon-Eye is a non-invasive cellular regeneration treatment.

Individual Treatment Options

Dry eye is a multifactorial disease.

The treatment of each person with dry eye disease is unique to their own situation.

Glenn Vessey implores that, “accurate diagnosis of the type of dry eye is essential.” Once that is achieved the best possible treatment can be tailored to the individual patient’s condition using a combination of treatment options.

When seeing an optometrist, you need to ensure that “they are continually updating their knowledge and skills relating to diagnosis and treatment of dry eye disease,” says Denise.

Dry eye is one of the most underrated diseases.

Symptoms in severe cases can be debilitating and have a detrimental impact on a patient’s lifestyle. Like many diseases, prevention is the best form of treatment.

If you want to find out more about dry eye disease book an appointment to see your local Eyecare Plus optometrist.

Dry eye disease can be extremely frustrating and upsetting for people who suffer from it.

It is a multifactorial condition which affects one in five adults, caused by a chronic lack of moisture to the surface of the eye.

Dry eye symptoms can range from a combination of a stinging or burning feeling, occasional blurred vision, redness, constant tiredness (like you always need to close your eyes) and/or the feeling that you have something like an eyelash in your eye.

Dry Eye Treatment

Treatment for mild dry eye disease can be in the form of artificial tears which lubricate the surface of the eyes.

If you are on the computer for long periods, take a break and look into the distance for 20 to 30 seconds to give your eyes a break. By focusing on a computer screen for long periods most people will blink less. As a result, our eyes become dry. Make a deliberate decision to take breaks from the screen and blink. Blinking renews the tear film which prevents dry spots on the eyes.

Drinking plenty of water, especially in hot weather, can help decrease dry eye symptoms, as will supplements containing omega-3 fatty acids.

For those with more severe dry eye symptoms, as part of an ongoing treatment plan, steroid eye drops are used short-term to treat the root cause of the inflammation.

Other treatments for long-term dry eye sufferers include a warm compress to the closed eyelid to soften and unclog the meibomian glands and intense pulsed light (IPL) treatment which flashes filtered wavelengths of light that are absorbed by the dilated blood vessels to reduce inflammation.

Mask Associated Dry Eye (MADE)

A new source of dry eye problem has arisen during the Covid pandemic – mask associated dry eye (MADE).

That is, a rise in dry eye cases due to the wearing of a poorly fitted face mask.

Wearing a mask helps to reduce the spread of the virus but can, if worn incorrectly, exacerbate dry eye symptoms when a person breathes out, spreading air upward toward the eyes.

Many people wearing a face mask for a long period of time who are not wearing their mask correctly, firmly against their face, are experiencing dry eye symptoms.

This is problematic, particularly for people who have an existing dry eye problem.

When wearing your mask, it is important to wear it snug against your face to help stop the air that you exhale from escaping upwards and over the surface of your eyes. If you wear a loose mask your breath will not only disperse out the sides but also upwards and across the ocular surface which could aggravate dry eye symptoms.

The Centre for Ocular Research and Education (CORE) recommend some simple solutions that can help stop or reduce the severity of dry eye symptoms when wearing a mask.

Dry Eye Solution Tips

1. Adjust your mask so that it fits firmly around your nose and under your eyes to stop your breath escaping upwards.
2. Artificial tears will help to lubricate your dry eyes and maintain moisture on the outer surface of your eyes.
3. Reduce the time you spend in air-conditioned environments
4. Give your eyes regular breaks from digital devices.

Wearing a mask correctly has played a critical role in reducing transmission of the global virus pandemic.

If you have questions about dry eye symptoms make an appointment to see your local Eyecare Plus optometrist who can advise you on an appropriate treatment plan.

Diabetes can affect the entire body, including your eyes.

It is a serious complex condition which requires daily self-care and, if complications develop, the condition can seriously impact the quality of a person’s life – even causing blindness.

Diabetes is debilitating. Not only can it lead to blindness, it can cause heart attacks, strokes, kidney disease, limb amputation, depression, and anxiety.

Less visible are the mental health complications of diabetes which impacts almost half of all people living with the disease, with many regularly experiencing moderate to severe anxiety or stress.

To help improve a person’s mental health, Diabetes Australia has launched a new campaign called Heads Up on Diabetes.

Heads Up on Diabetes

The mental and emotional health challenges of living with diabetes are very real.

“Nearly half of all adults with diabetes experience mental health challenges, including diabetes related anxiety, distress and depression during their lives,” says Diabetes Australia CEO Professor Greg Johnson.

Heads Up on Diabetes, launched during National Diabetes Week 2020, is designed to raise awareness of the mental health burden associated with diabetes and encourage people to seek help if they need it.

Living with Diabetes is not only stressful, managing it is time consuming and requires a great deal of organisation to get through each day including keeping track of medications, blood glucose monitoring, and constant ongoing health checks.

Mental Health Challenges

Research shows that living with a chronic condition like diabetes can more than double a person’s risk of developing depression.

“Two-thirds of people with diabetes are worried about their long-term risk of developing serious diabetes-related complications like losing limbs, eyesight, experiencing kidney failure or heart failure,” says Professor Greg Johnson.

“The mental health challenges associated with living with diabetes can make it harder for people to manage their physical health and increase their risk of developing serious diabetes-related complications.”

People living with diabetes need to stay on top their routine health checks including having regular eye examinations, which will help decrease the risk of depression.

KeepSight

A national diabetes eye health register; KeepSight, encourages people living with the disease to have regular eye examinations.

The program has been running for two years and has had a significant impact on the eye health of Australians with more than 66,000 people with diabetes now enrolled in the program.

Receiving these reminders is a great way to help people to stay on top of appointments that are set months, and sometimes, years in advance.

People living with diabetes may not experience symptoms. Many can feel that there is no need to have their eyes examined and that if everything checked out last time, then they can miss their next eye appointment or two.

Diabetic Retinopathy

Diabetic eye disease can cause a range of eye problems, the most common being Diabetic Retinopathy, in which the blood vessels inside the retina at the back of the eye are damaged.

The disease is subtle with no warning signs, so it can be easy to neglect regular eye checks. The problem though is that without annual eye examinations, diabetic eye disease can cause permanent vision loss.

Many Australians with diabetes lose their sight each year, but this can be avoided by having regular eye tests.

To find out more about diabetes visit www.diabetesaustralia.com.au or contact 1800 533 774 to arrange a free conversation with a trained psychologist.

It is important, if you have diabetes to see your local Eyecare Plus Optometrist each year to have a thorough eye examination. Book an appointment today.