Living with diabetes, I’ve been told many times that I need a retinal eye exam every year. I’m told this by my health insurance, by my doctors, by every diabetes awareness council out there. Now, I’m spreading the message, but with a difference.
None of these sources ever told me WHY I needed a retinal eye exam. I found them to be quite an ordeal and never kept up with them. Now I am paying the price.
Things I’ve learned about 2 1/2 years ago:
I was legally blind.*
There is such a thing as an eyeball injection.
No matter what Ophthalmologist tells you, eyeball injections feel exactly the way you imagine they feel.
By the time you notice symptoms of diabetic eye problems, you’re already at the point where you probably need said injection and maybe even surgery (and not the laser kind… the scalpel kind).
*”Was” is the operative word there. Fortunately, in my case, much of the damage was still reversible.
About ten years or so ago, I was having some vision problems and figured it was time to go in and get a new pair of glasses. I had been prescribed lenses in the past for my astigmatism, but they were not very strong and I almost never wore them. I figured that the years had worsened the problem and maybe it was time to give in and get a new pair. I had excellent vision benefits at my job, so there was no reason to put it off any longer.
Through the refractive examination (that’s where they put different lenses in front of you and you tell them which is better) we reached a point where there was improvement, but they couldn’t get me to 20/20. That’s when they gave me my first retinal exam, and problems were found.
I was diagnosed with Diabetic Retinopathy. This occurs when blood vessels in the retina are damaged as a result of diabetes. These damaged blood vessels are no long able to adequately nourish the retina, so your body responds by growing new blood vessels. However, it doesn’t do a very good job of it, and these new blood vessels are prone to leakage.
I was treated with a laser to seal off those blood vessels and was warned that I needed to keep my blood sugar and blood pressure under control to avoid further complications. My vision at this point did suffer some permanent damage. There were small areas in my field of vision that just didn’t work anymore. I didn’t notice until I began looking for it that my brain was filling in these gaps subconsciously. I found that if I looked at printed text with one eye closed, it became more apparent. I could see places where the text would warp to fill in one of the holes.
The exam itself was unpleasant, but the treatment was a nightmare. The exam involved shining a bright light in my eye to illuminate my retina while the doctor looked into my dilated pupils while the doctor used a magnifying lens to look examine the retinal surface. The treatment involved a device to hold my eye open, while a lens was pressed against my eye to flatten the cornea while lasers were shot at the blood vessels. Those appeared as even more super bright lights, and I could feel a burning sensation inside my eye. I was glad when that was finally over.
The following year, the memory of my last visit still very fresh in my mind, I was hesitant to go back for another checkup. I ended up not going. After all, my vision hadn’t changed any, so I didn’t think there was any need to go back.
The following year, I found a similar excuse. The year after that, well, I just didn’t bother. Nor did I bother the following year, nor the one after that… This was a mistake.
Fast forward a bit. At least, that’s what it feels like. The years go by so quickly now. I found myself noticing what I thought was shoddy workmanship on the bathroom tile. The grout was all crooked and it made the tiles look like the edges were indented. After a few weeks, I realized it wasn’t the tile at all. It was my eyes. I didn’t have any medical insurance by then, so rather than make an appointment, I put it on my list of things to get checked out once I had insurance again. Another mistake.
Months pass. I got new insurance through my new job. I began noticing my vision is noticeably worse than it had been in the past. However, it was November, I had just moved, the holiday season was beginning, there was surely no time to be making doctor appointments. I’m just making all kinds of mistakes here.
About a month into the new year, 2013, I found an ophthalmologist that accepted my insurance and scheduled an appointment. I had my appointment on a Friday afternoon. After a few standard tests, the ophthalmologist took pictures of my retina. After looking them over he told me I needed to see a retina specialist right away. And he meant RIGHT AWAY. He didn’t want me to wait until Monday. He made some calls and found someone who could see me that day.
I was immediately sent to a retinal specialist. The news was bad. I had more issues with Diabetic Retinopathy, and also Diabetic Macular Edema. The macula is a small indentation in the back of the eye, in the middle of the retina, near the optic nerve. This area was severely swollen, due to fluid leakage from all of those haphazardly formed blood vessels, leading to further warping of my vision, and also it gives things kind of a washed out look, like if you have your TV set too bright and the contrast too high. It makes it hard to see detail. It had gotten to a point where I could barely read my computer monitor anymore, and driving had become dangerous.
These issues would have been detected with regular eye exams, and they could have been solved before causing damage to my vision. At the time of the diagnosis, my vision was 20/400 in my left eye, and 20/200 in my right (legally blind).
I’ve been undergoing treatment for about two and a half years. Those treatments have included several more lasers, monthly injections of medicine into each eye (which those have come to an end about 3 months ago), and one surgery on my left eye. I may still need surgery on my right eye in the near future.
All in all, the treatments have been an ordeal, but, combined with keeping my blood sugar under better control than ever, they are working. My uncorrected vision right now is 20/50 and 20/40.
I wish I knew ten years ago what I do now. I certainly would have opted to take the inconvenience of an annual exam. Many diabetic eye conditions don’t affect your vision until they are fairly advanced. A retinal eye exam can reveal issues before you become symptomatic.
For more information about Diabetic Eye diseases, their causes, diagnoses and treatment, please contact your eye care specialist. Don’t put it off.