Diabetes can affect a person’s eyesight in many ways.
The American Diabetes Association reports that diabetics are 40% more likely to develop glaucoma, 60% more likely to develop cataracts and they are also susceptible to additional sight complications such as macular edema and retinopathy.
Summit Medical Group board-certified ophthalmologist Monica Khalil, MD, discusses these conditions and the critical importance of eye care – including an annual eye exam – for people with diabetes.
Selected Podcast
Diabetes and Eye Health
Featured Speaker:
Monica Khalil, MD
Monica B. Kahlil, MD, is a member of the American Academy of Ophthalmology. Dr. Khalil has been featured in the New Jersey Monthly "Top Doctors" listings. Transcription:
Diabetes and Eye Health
Melanie Cole (Host): Diabetes can affect a person’s eyesight in many ways. The American Diabetes Association reports that diabetics are 40 percent more likely to develop glaucoma, 60 percent more likely to develop cataracts, and they are also susceptible to additional sight complications such as macular edema and retinopathy. My guest today is Dr. Monica Khalil. She’s a Summit Medical Group board-certified ophthalmologist. Welcome to the show, Dr. Khalil. Tell us a little bit about the link between diabetes and eye health. What’s going on?
Dr. Monica Khalil (Guest): Well, thank you for having me. Diabetes is the most common cause of new cases of blindness among adults aged 20 to 75. It certainly is one of our biggest health concerns that we look for in each diabetic. Of course, we evaluate overall general health, but we are concerned that if we don’t preemptively test patients and evaluate their eyesight and evaluate the health of their retinas, that they may actually go on to lose vision if it’s not treated appropriately. In fact, each year, between 12,000 and 24,000 people actually lose their sight because of diabetes. One of the primary reasons this happens is people who do not have appropriate ophthalmic examinations or do not carry on these examinations with appropriate frequency.
Melanie: How often should they see an ophthalmologist if they are someone with diabetes?
Dr. Khalil: A type 1 diabetic should be screened within three to five years of diagnosis, and they should be seen annually. A type 2 diabetic should be screened at the time of diagnosis and should also be evaluated annually.
Melanie: Then what? Is there something that you want them to do prophylactically while they’re trying to control their diabetes, obviously? Is there something they can do to help protect their vision as well?
Dr. Khalil: Certainly, the most important thing as you said is controlling their glycemic index or controlling their blood sugar. Other than that, it’s just having those regular eye exams. That’s really all that can be in the patient’s control.
Melanie: Now, what if they do have retinopathy or macular edema? You start to see one of these things happening. What are some treatments? Are there things that you can do to slow down the progression?
Dr. Khalil: Certainly. In fact, the first thing we do, we have very strict guidelines when it comes to treating diabetes. So if you see just mild signs of diabetic retinopathy, we would probably just observe, but we would increase the frequency of follow-up visits. With mild, non-proliferative diabetic retinopathy, we may say, okay, we’d like to see the patient in four to six months rather than just annually. If we see more than that, the patient may then, at that point, benefit from a type of laser procedure which is performed on the retina, and that reduces the likelihood of creating further diabetic retinopathy in the future. Of course, in very severe cases, there may be additional treatments, which include injections into the eye of certain medications that can, again, slow down the process. The mainstay of treatment is laser photocoagulation when it gets to the point that that’s necessary.
Melanie: Does that photocoagulation slow down or cease the process, and then does it come back? Is this something that works in the long term?
Dr. Khalil: It certainly can slow down the process, if not completely cease it. The idea is that basically, you’re eliminating the retina’s demand for new blood vessel. When we place laser holes in the retina, you’re minimizing how much oxygen the retina is demanding. And in many cases, this can actually cease any further deterioration or progression of diabetic retinopathy. Can it come back in the future? It can. It’s always possible that it can, but with good laser treatment, it’s rare, and I would say that with good laser treatment, people still will require their regular follow-up but they’re less, much less likely to have these kinds of events that will actually produce loss of vision.
Melanie: Tell us, Dr. Khalil, what research is being done to learn more about diabetic eye diseases?
Dr. Khalil: Well, there is a lot of money being put into this right now. The mainstay is what can be done to slow down your body’s attempts to create more of these blood vessels. Basically, when the eye is starved of oxygen, it only knows of one way to get that oxygen, which is to create new blood vessels. And those blood vessels are often faulty and they leak and they bleed. The idea is to, again, minimize your eye’s need for that. And a lot of these newer drugs that are coming out are in an effort to quell the eye’s need for more oxygen. And basically these are anti-VEGF—it’s the term that’s being used—drugs which really have been very promising in terms of their results. They are used in diabetics, and they are even also used in macular degeneration patients.
Melanie: Dr. Khalil, in just the last few minutes, please give the listeners your best advice about diabetes and protecting their eye health and why they should come to Summit Medical Group for their eye care.
Dr. Khalil: Well certainly, my best advice is to keep up with your annual eye exam. Don’t let that fall by the wayside. Control your blood sugar as much as you possibly can. And I know it’s such a tall order for people because, really, everything affects blood sugar. But to realize that this really affects your long-term eye health and that you only get two eyes, so it’s important to really take care of them. Along with that, you should also of course control your blood pressure and your other health problems because they can also contribute to this process. But so long as you do your best, usually most will really do well and we catch things early. I think Summit Medical Group does a fantastic job of working on preventative health. And if we see the beginnings of change, we’re pretty quick to jump on top of that and get you treated the right way.
Melanie: Thank you so much. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Diabetes and Eye Health
Melanie Cole (Host): Diabetes can affect a person’s eyesight in many ways. The American Diabetes Association reports that diabetics are 40 percent more likely to develop glaucoma, 60 percent more likely to develop cataracts, and they are also susceptible to additional sight complications such as macular edema and retinopathy. My guest today is Dr. Monica Khalil. She’s a Summit Medical Group board-certified ophthalmologist. Welcome to the show, Dr. Khalil. Tell us a little bit about the link between diabetes and eye health. What’s going on?
Dr. Monica Khalil (Guest): Well, thank you for having me. Diabetes is the most common cause of new cases of blindness among adults aged 20 to 75. It certainly is one of our biggest health concerns that we look for in each diabetic. Of course, we evaluate overall general health, but we are concerned that if we don’t preemptively test patients and evaluate their eyesight and evaluate the health of their retinas, that they may actually go on to lose vision if it’s not treated appropriately. In fact, each year, between 12,000 and 24,000 people actually lose their sight because of diabetes. One of the primary reasons this happens is people who do not have appropriate ophthalmic examinations or do not carry on these examinations with appropriate frequency.
Melanie: How often should they see an ophthalmologist if they are someone with diabetes?
Dr. Khalil: A type 1 diabetic should be screened within three to five years of diagnosis, and they should be seen annually. A type 2 diabetic should be screened at the time of diagnosis and should also be evaluated annually.
Melanie: Then what? Is there something that you want them to do prophylactically while they’re trying to control their diabetes, obviously? Is there something they can do to help protect their vision as well?
Dr. Khalil: Certainly, the most important thing as you said is controlling their glycemic index or controlling their blood sugar. Other than that, it’s just having those regular eye exams. That’s really all that can be in the patient’s control.
Melanie: Now, what if they do have retinopathy or macular edema? You start to see one of these things happening. What are some treatments? Are there things that you can do to slow down the progression?
Dr. Khalil: Certainly. In fact, the first thing we do, we have very strict guidelines when it comes to treating diabetes. So if you see just mild signs of diabetic retinopathy, we would probably just observe, but we would increase the frequency of follow-up visits. With mild, non-proliferative diabetic retinopathy, we may say, okay, we’d like to see the patient in four to six months rather than just annually. If we see more than that, the patient may then, at that point, benefit from a type of laser procedure which is performed on the retina, and that reduces the likelihood of creating further diabetic retinopathy in the future. Of course, in very severe cases, there may be additional treatments, which include injections into the eye of certain medications that can, again, slow down the process. The mainstay of treatment is laser photocoagulation when it gets to the point that that’s necessary.
Melanie: Does that photocoagulation slow down or cease the process, and then does it come back? Is this something that works in the long term?
Dr. Khalil: It certainly can slow down the process, if not completely cease it. The idea is that basically, you’re eliminating the retina’s demand for new blood vessel. When we place laser holes in the retina, you’re minimizing how much oxygen the retina is demanding. And in many cases, this can actually cease any further deterioration or progression of diabetic retinopathy. Can it come back in the future? It can. It’s always possible that it can, but with good laser treatment, it’s rare, and I would say that with good laser treatment, people still will require their regular follow-up but they’re less, much less likely to have these kinds of events that will actually produce loss of vision.
Melanie: Tell us, Dr. Khalil, what research is being done to learn more about diabetic eye diseases?
Dr. Khalil: Well, there is a lot of money being put into this right now. The mainstay is what can be done to slow down your body’s attempts to create more of these blood vessels. Basically, when the eye is starved of oxygen, it only knows of one way to get that oxygen, which is to create new blood vessels. And those blood vessels are often faulty and they leak and they bleed. The idea is to, again, minimize your eye’s need for that. And a lot of these newer drugs that are coming out are in an effort to quell the eye’s need for more oxygen. And basically these are anti-VEGF—it’s the term that’s being used—drugs which really have been very promising in terms of their results. They are used in diabetics, and they are even also used in macular degeneration patients.
Melanie: Dr. Khalil, in just the last few minutes, please give the listeners your best advice about diabetes and protecting their eye health and why they should come to Summit Medical Group for their eye care.
Dr. Khalil: Well certainly, my best advice is to keep up with your annual eye exam. Don’t let that fall by the wayside. Control your blood sugar as much as you possibly can. And I know it’s such a tall order for people because, really, everything affects blood sugar. But to realize that this really affects your long-term eye health and that you only get two eyes, so it’s important to really take care of them. Along with that, you should also of course control your blood pressure and your other health problems because they can also contribute to this process. But so long as you do your best, usually most will really do well and we catch things early. I think Summit Medical Group does a fantastic job of working on preventative health. And if we see the beginnings of change, we’re pretty quick to jump on top of that and get you treated the right way.
Melanie: Thank you so much. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.