Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million. 

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.  

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring. 

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes. 

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy. 

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness. 

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages. 

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy. 

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision. 

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss. 

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids. 

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes. 

Brush Up Before You Dress Up

Halloween is one of the most fun times of the year for children and adults alike. When else do you get to dress up as anyone (or anything) you want, socialize with friends and eat lots of treats? Nevertheless, lurking behind those costumes and all that fun are some hidden dangers that you need to be aware of and many of them could affect your eyes and vision. Brush up on these preventative measures to help you and your children to stay safe and enjoy the holiday. 

Masks

Masks can really make or break a costume but they can also increase danger, especially for children. Masks that block visibility or the ability to breathe can be extremely dangerous. You want to make sure that you and your children have a complete, unobstructed visual field, especially if they will be crossing streets. 

Facepaint

Facepaint can be a great alternative to a mask, but it comes with its own set of precautions. Buy face paint that is hypoallergenic and do a spot test to make sure there is no allergic reaction anyway. Make sure to keep the paint out of the eyes and be careful during application especially with sharp, pointed brushes that can scratch the eye. If face paint or any other substances get into the eyes, immediately flush the eyes thoroughly with saline or water as chemical splashes can cause significant eye damage within minutes. This should be done before consulting your eye doctor. If irritation persists however, it should be looked at by an eye doctor. 

Props

Try to avoid costumes with sharp or pointed props such as spears, swords or guns that shoot. Warn children at play to never point an object at a person’s head or eyes. 

That goes for spray cans of silly-string, as well. The chemicals in these products can be very dangerous to the eyes, risking chemical conjunctivitis and serious eye irritation. The pressure at which the string is sprayed can also cause eye damage including a corneal abrasion (a scratch to the surface of the eye) if sprayed into the eye at a close range. These popular Halloween products should be avoided or, if necessary, children should be seriously cautioned not to spray anyone near the neck or face. 

Visibility

Speaking of sight, you want to make sure that you and your children are visible to motorists on the streets. Chose brightly colored costumes and carry a flashlight to increase visibility. Consider adding some reflective tape to the costume or props as well.

Decorative Contact Lenses

Decorative contact lenses can look great, but they can cause serious damage. That’s why even non-corrective contact lenses are considered a medical device, which must be approved by the Food and Drug Administration or Health Canada, and require a prescription from an eye doctor. 

Never buy fashion, decorative, cosmetic, colored or theater contact lenses (or any other name that they go by) from a beauty or costume supply store or any unauthorized vendor. You should purchase them only with a prescription from an eye doctor after an eye exam to measure your eye and assess your eye health. 

Why?

Contacts obtained through an unauthorized source may not be safe to wear. They might cause a corneal abrasion, allergic reactions, infections and decreased vision which can even lead to blindness.  

Plus, your optician or eye doctor will give you instructions for proper use and hygiene such as washing your hands, storing and cleaning the lenses properly and removing them as prescribed.  

If you are wearing any type of contact lenses and you notice redness, pain or blurred vision, take them out immediately. If symptoms persist, see your eye doctor as soon as possible. 

Stay Safe

Don’t make Halloween into a truly scary holiday. Take heed of these potential dangers and take the necessary precautions to stay safe. Happy Halloween!

Regular exercise is an essential component of overall health and wellness. It is proven that exercise reduces sickness and disease; it increases strength, immunity, and mental health; and it also helps regulate bodily functions and maintain a healthy weight. Research shows that exercise can lower our risk of chronic conditions such as high blood pressure, heart disease, diabetes, diabetic retinopathy and diabetic macular edema, as well as other eye diseases such as glaucoma, cataracts and wet age-related macular degeneration (AMD).

Whereas, a sedentary lifestyle increases the risk of these diseases and of vision loss, studies show that even moderate exercise at least three times a week can improve the prognosis of the above-mentioned chronic illnesses and reduce the risks of developing vision threatening eye diseases. 

Inactivity is an even higher risk factor if you have other co-factors for developing eye diseases, including: a family history, previous eye injury or surgery, diabetes, high blood pressure or very high myopia. A combination of healthy lifestyle habits which include regular exercise and a nutritious diet and tending to your mental and emotional well-being can reduce these risks significantly.

Tips for Incorporating Physical Activity Into Your Day

1. Make it a priority. Schedule your exercise time into your day as if it is a non-negotiable appointment. Find the time of day that works best – for some that is early morning and for others late at night. Work your way up to a half hour at least three times a week. 
2. Be realistic. You don’t need to become a fitness expert to experience the benefits of exercise. Walking, yoga, swimming, even dancing around the house are all options for staying fit. Find a type of exercise that you love so you will enjoy working this habit into your life.
3. Just move. Find ways to move your body throughout your day. Park your car a little further away from the mall entrance, take the stairs instead of the elevator or walk or bike to work. Remember, every little bit of movement helps.
4. Find something you enjoy. Often finding the right exercise is a good stress reliever, and reducing stress will also reduce risk of many chronic diseases.
5. It’s never too late. Exercise for the elderly can be a challenge especially during the cold winter months, when many seniors can’t get out of the house due to the weather. Even walking up and down the stairs in the house or following an exercise video can be helpful to keep from being sedentary.

Protection & Prevention

If you are exercising outdoors or playing contact sports, make sure to protect your eyes with sunglasses or sports safety glasses to ensure your eye health and safety. 

Regular exercise can significantly decrease your risks of certain eye conditions but you still have to ensure that you visit your eye doctor for regular exams. Schedule a comprehensive eye exam every year to ensure your vision and your eyes are healthy and to catch any possible problems as early as possible.

Eye health and disease prevention are just two of the many health and wellness benefits you gift yourself when you make exercise a regular part of your lifestyle. Speak to your doctor if you have any health issues that need to be considered. At any age or level of physical fitness, you can find some form of exercise that works for you. 

What Is Progressive Myopia?

Nearsightedness or myopia is one of the most prevalent eye disorders worldwide and its incidence is increasing. In fact by 2050, myopia is projected to affect half of the world’s population!

Many children diagnosed with nearsightedness (myopia) experience a consistent worsening of their vision as they grow into adolescence. This condition can be so aggressive that for some, each time they take their child to the eye doctor for a vision checkup, their prescription gets higher. 

This is called progressive myopia and can be a serious condition for many children now and in the future. Not only is there a financial burden and inconvenience associated with having to replace eyeglasses on a regular basis, but high myopia is a risk factor for many eye diseases later in life such as retinal detachment, early onset cataracts, glaucoma and macular degeneration. 

What Causes Progressive Myopia?

Myopia is a refractive error that happens when the eye focuses incoming light in front of the retina, rather than directly on it, resulting in blurred distance vision. While an exact cause of progressive myopia is not known, most research indicates that a combination of environmental and genetic factors trigger the condition. 

First of all, there is evidence that a family history of nearsightedness is a contributing factor. Additionally, spending a lot of time indoors may play a role in myopia development, as studies show that children who spend more time outside have less incidence of myopia. Lastly, near point stress, which can be caused from looking at a near object for an extended period of time, can prompt the eye to grow longer and result in myopia. Several eye doctors recommend following the 20-20-20 rule when using digital devices (stopping every 20 minutes to look 20 feet away for 20 seconds) to reduce near point stress caused by computer use. 

What Can Be Done To Prevent or Treat Myopia?

There are several treatments that have been shown to slow the progression of myopia.

Orthokeratology (ortho-k):

Also known as corneal reshaping, this treatment uses rigid gas permeable contact lenses that are worn while the patient sleeps to reshape the cornea, which is the clear, front part of the eye. During the day, the patient is usually able to see clearly, glasses-free. In addition to allowing glasses-free vision during the day, this treatment has been shown to reduce the progression of myopia in many children. 

Distance Center Multifocal Contact Lenses:

This treatment uses distance center (which means the area for seeing at a distance is in the center of the lens) multifocal soft contact lenses to provide clear vision and slow the progression of myopia. The lenses are worn as normal contact lenses during the day.

Atropine Drops:

Atropine drops are a daily-use prescription eye drop that has been shown to reduce myopia progression. It can be used alone or in combination with ortho-k or multifocal contact lenses. 

Additional Myopia Treatments:

While these treatments are available in all of North America, some countries offer additional options that are approved for myopia control. For example, in Canada, Zeiss^TM MyoVision glasses that have an innovative lens curvature design are available to help reduce the rate of myopia progression. Additionally some doctors in Canada offer Coopervision MiSight^® lenses, which are 1-day contact lenses that are worn during the daytime. These contacts have a multifocal lens design with distance centre and near surround that is specifically designed for children. 

Myopia & Your Child

If your child’s vision keeps getting worse, it’s more than an annoyance – it can be a serious risk factor for their eye health and vision in the future. The best strategy for myopia control depends on the child and the severity of the case, and requires consultation with an experienced eye doctor in order to determine the best solution. If your child wears glasses, make his or her vision a priority; schedule an eye exam to ensure stable vision and healthy eyes. 

An online eye test may seem like a convenient way to check your vision or get an eyeglass prescription but beware, these tests aren’t all they are chocked up to be. In fact, they may even be dangerous. 

What is an online eye test really testing? 

An online eye test is actually not an eye test at all but just a vision or sight test – and a partial test at that.  It is designed to measure your visual acuity and refractive error (nearsightedness, farsightedness or astigmatism) and to determine an eyeglass prescription – which is the lens power needed to correct the refractive error in your vision. 

Given that there is no one with medical training actually performing or checking the accuracy of the test, it is questionable how well the exam does even this. In fact, when an eye doctor does a refraction for glasses or contact lenses it also involves some judgement on the doctor’s part.  The eye doctor will often adjust the prescription slightly based on the patient’s age, occupation or hobbies.  The doctor may prescribe a prism in the lenses to help with binocularity and to prevent double vision in those who have deviations of the eye. There is no way an online exam can do any of this. 

Further, a refraction is only one very small part of an eye exam and if it takes the place of a regular comprehensive eye exam by an eye doctor, you put your eyes and vision at serious risk. 

A Comprehensive Eye Exam – Where Online Tests Fail

Even if the eyes see clearly and you have 20/20 vision, there may still be vision problems or eye disease present even without pain, blurred vision or other symptoms.  What the online eye test fails to measure is your complete visual health and capacity (beyond just visual acuity), the curvature of the eye (which is needed for accurate lens prescriptions- especially for contact lenses) and an assessment of the health of the eye itself. 

Just as we need regular medical and dental checkups as a part of preventative health care to prevent disease and maintain our health, we also need regular eye exams. A vision test  does not suffice. A comprehensive eye exam will examine much more than just how well you see. It will also check for visual processing, color vision, depth perception and proper eye movement.  It will measure your eye pressure, examine the back of your eye and look for early signs of eye disease or conditions such as glaucoma, macular degeneration, diabetes, tumors and high blood pressure – many of which threaten your eyes and vision if not caught early. 

If you do have some vision loss, the doctor will be able to determine if there is any serious underlying problem that is causing the disturbance in your vision. If you don’t have symptoms that doesn’t mean there isn’t a problem. Many serious eye conditions develop gradually without any symptoms. Some eye diseases do not affect the macula, and therefore you may still have good vision even though there is a problem (such as glaucoma, early dry macular degeneration, early cataract, diabetes, blood pressure and even tumors). Many of these conditions threaten the eyes and even general health if not caught early and when undetected they can cause permanent and irreversible damage to your vision 

Eye exams are the best way to detect these early and treat them before they develop into serious eye problems. 

Whether online vision tests are inaccurate, misleading or simply insufficient, they can fail to provide essential information and can delay or prevent vision saving treatments. Additionally, you could be walking around with the wrong vision prescription which can cause unnecessary eye strain, headaches and difficulty.  

Will an Online Eye Test Really Save you Money?

No. Besides the fact that most eye exams are covered by insurance, the eye exam you are getting from an eye doctor is much more thorough and comprehensive than an online eye test, so you are not comparing apples to apples.  The eye doctor’s exam uses real equipment and performs a complete and professional evaluation of your vision and eye health. There is simply no comparing this to a self administered test on a computer screen. 

An online eye test may be touted as a time and money saving convenience however, that is hardly the case. An eye exam is a medical procedure that requires training, precision, and proper equipment.  Anything less can put your eyes and vision at serious risk.