As vitreoretinal surgeons and ocular oncologists, we have the privilege of intervening as guardians of sight every single day. While this proves to be an incredibly rewarding vocation, it comes with the supreme responsibility of being the final bastion defending against aggressive pathology trying to wreak havoc on the ever-so-delicate retina, which interfaces images of the outside world to the brain. Easily, no pathology has been more humbling through this journey than has been diabetic retinopathy. Inevitably, when witnessing someone’s vision deteriorate swiftly from this disease, the other eye is losing ground just a step behind. The bilaterality of diabetic retinopathy is often most challenging for younger type 1 diabetics who form aggressive scar tissue at the retinal surface that insists on stealing vision. Far too often, we are left putting together the pieces of a missed opportunity – the opportunity to avert vision loss if we could have met that patient just months earlier. 

So, Diabetic Eye Disease Awareness Month is a great time to pause and review a few details:

• Blindness is the number one disabling complication of diabetes.

• More diabetics fear going blind than any other complication of diabetes, including going on dialysis, having a stroke, or even suffering a heart attack. 

• An additional 50,000 Americans will go blind this year, and diabetic retinopathy will be the leading cause of preventable blindness overall and the leading cause of blindness in working-age adults. 

Now here are the real kickers:

• Nearly 60% of Americans with diabetes do not get an annual eye exam. 

• 95% of vision loss from diabetes is preventable just by taking that one step. 

One of the real challenges with diabetic retinopathy is that the overwhelming majority of patients who develop it have absolutely zero symptoms until the very late stages. By the time symptoms actually develop, the rate of progression and risk of permanent visual loss can accelerate quite rapidly. It is a unique entity from many other eye diseases, in that consistent annual surveillance needs to be considered an intrinsic component of its management. 

As we approach the month of November, let’s commit to being more cognizant of this gap, partner together to eradicate diabetic blindness, and commit in making the coming year 2020 the year we take the big stride forward in eradicating diabetic blindness here in Hampton Roads.

Kapil G. Kapoor, MD  is a Board certified ophthalmologist specializing in vitreoretinal surgery.   wagnerretina.com