A common side effect of a diabetic’s uncontrolled blood sugar is damage to the eyes.
The condition, called diabetic retinopathy, can lead to blindness and is one of the most common complications of diabetes. Approximately 4 million people in the United States are living with the disorder, according to the Centers for Disease Control and Prevention.
In addition to its commitment to researching diabetic retinopathy, the Department of Ophthalmology at Indiana University School of Medicine is working to establish a Diabetic Eye Care Program, which would offer specialized treatment for those who suffer from the disorder.
This program is a “collaborative unit involving a multidisciplinary approach in treating patients with diabetic eye disease and improving clinical outcomes,” said ophthalmology faculty member Denis Jusufbegovic, MD, who is leading the charge toward the program’s creation.
Diabetic Eye Care Program would allow doctors to work more closely while managing patients’ diabetes; have diabetic educators present on site in the clinic; provide social and psychological support to patients; and lead IU telemedicine screening programs.
Patients would be seen at the Eugene and Marilyn Glick Eye Institute and a planned satellite office.
Here, Jusufbegovic answers questions about the future program and why it’s important:
How did plans for the Diabetic Eye Care Program come about?
A plan for this program came from a fundamental idea that our department is the only academic institution in the state and it is in a great position to serve as a leading place for diabetic eye care in Indiana.
Diabetic retinopathy is a leading cause of permanent vision loss in the working-age population (ages 18-65) and has a significant impact on the quality of life in diabetic patients. Incidence and prevalence of diabetes and, consequently, the incidence and prevalence of diabetic retinopathy are significantly on the rise in the U.S., including in Indiana, and there is a significant need for diabetic eye care. We are also in a great position because IU School of Medicine has one of the world-renowned centers for diabetic research, the Center for Diabetes and Metabolic Diseases.
Why is it important to have a program like this in Indiana?
By creating a specialized clinic and focusing specifically on diabetic eye care, we will be able to improve patients’ outcomes through a focused and collaborative approach, which will benefit patients in Indiana. Our existing clinics already have trained diabetic educators (from the IU diabetic education team) who are providing diabetic education to our patients. We will also focus on improving communication methods with physicians managing diabetes. Our goal is to have dedicated social workers and support groups for our patients.
What complications of diabetes will be addressed by this program?
The primary goal of the program is to focus on patients who already have vision-threatening complications from diabetes, such as diabetic macular edema, proliferative diabetic retinopathy, and tractional retinal detachment. Our goal is also to work closely with the patients and prevent the progression of their retinopathy.
Will any research be done there?
Yes, research will be done here. We participate in DRCR Retina Network, which is the preeminent research network conducting clinical trials in ophthalmology. Having a specialized clinic for diabetic patients will improve our ability to recruit patients for clinical trials. Additionally, we will be working closely with our basic science department to conduct translational research projects to advance our understanding and treatments for diabetic retinopathy.
How will the program utilize telemedicine eye screenings?
Our department is working closely with the primary care department in establishing a telemedicine screening program. We are currently finalizing the nuts and bolts of our program and will be using the Welch Allyn system to screen patients in primary care offices. Our clinicians will be reading images. Our team will arrange follow-ups in our clinic for patients who have abnormal results.
How will IU School of Medicine learners benefit from working in a program like this?
The education component is an integral part of our program. Our goal is to function as a leading educational program for promoting understanding of diabetic retinopathy. We hope to provide educational seminars for medical professionals, such as research seminars, continuing medical education courses for ophthalmologists, and seminars for nurses, medical students, primary care doctors and endocrinologists; and to provide educational seminars for the broader community about the importance of prevention and early treatment of diabetic complications to prevent permanent end-organ damage.
What is diabetic retinopathy?
Diabetic retinopathy is a complication of diabetes in which abnormal blood sugar levels cause damage to the blood vessels in the retina, compromising vision and potentially causing blindness.
Poorly controlled blood sugar, large glucose fluctuations and longer duration of a diabetes diagnosis increases the risk of this disorder, said Samantha Polster, OD, an assistant professor of ophthalmology for IU School of Medicine, who specializes in treating the disorder.
“The tricky thing is, often patients don’t experience any symptoms of diabetic retinopathy in the beginning,” Polster said. “Blurry or distorted central vision can be a sign of diabetic retinopathy, along with new floaters or dark spots in the vision. A yearly dilated eye exam is so important to catch signs of retinopathy before it decreases vision.”
Diabetic retinopathy is managed differently depending on the patient and the severity and type of retinal changes,” Polster said. “Sometimes patients will have laser treatments, injections inside of the eye, surgery or a combination of those,” she said.
Controlling blood sugar and blood pressure are the best ways to prevent changes to the vessels in the retina, Polster said.
