Tell Patients that DR is Often Asymptomatic

 

 

 

 

 

Once a patient is diagnosed as diabetic, they “should be educated that DR is often asymptomatic. Specifically, patients who have diabetes and early stages of DR should be reminded at each visit that their perception of their eyesight is not an indicator of a lack of disease progression and/or need for intervention and treatment. Optometrists can refer to the Early Treatment Diabetic Retinopathy Study (ETDRS), which shows that, in most cases the actual functional vision loss may not be discerned until the patient has reached the ETDRS severity levels of 43 to 47, corresponding to moderate, to moderately severe non-proliferative DR (NPDR).” – Mohammad Rafieetary, OD, FAAO, FORS, ABO, and Salar Rafieetary, MD, “Address This Top Challenge in Managing Diabetes."

 

Educate DR Patients on How Blood Sugar Can Affect Ocular Health

 

 

 

Patient education is the first step when treating diabetic corneal patients. “… optometrists need to first provide patient education on how blood sugar levels are related to ocular dryness, in addition to DR. From there, ODs must convey the importance of better blood sugar control. Optometrists should make sure to communicate with the patient’s treating physician and, possibly, suggest the patient see a dietician for guidance.” – Cecelia Koetting, OD, FAAO, “Consider the Cornea in Diabetes.”

 

Take Advantage of the Latest Diagnostic Devices

 

 

 

With the number of people suffering from diabetes increasing, so too does the number of those with DR. To help manage these patients, doctors should take advantage of the latest diagnostic devices and personal patient devices. “OCT angiography (OCTA) can aid ODs in detecting subclinical microaneurysms at the deep capillary plexus and other vascular anomalies (e.g., vascular loops, tortuosity and dilations of the vessels), intraretinal microvascular abnormalities, and neovascularization.” Other technologies discussed include fundus photography, fluorescein angiography, and personal patient devices. – Sherrol A. Reynolds OD, FAAO, “Keep Tabs on Diabetes.” 

 

Pay Attention to Dietary Profiles

 

 

 

A patient’s diet can have a big effect on their DR. “Concentrating on dietary profiles rather than specific nutrients is proving to be more beneficial due to the synergistic effects of the different nutritional components in an entire diet. In 2018, Wong et al conducted a systematic review of dietary patterns and DR that showed higher intakes of dietary fiber, fruits and vegetables, oily fish, and a greater adherence to a Mediterranean diet were protective of DR.” – Julie Poteet, OD, MS, CNS, FOWNS, “How Nutrition Impacts Diabetic Eye Disease.” 

 

Diagnose TED Early

 

 

 

Early diagnosis is crucial for TED patients. “Most TED patients present with bilateral ocular symptoms that are often asymmetric. These patients may complain of dry eyes, ocular irritation, itching, redness, tearing, grittiness, diplopia, pain upon eye movement, light sensitivity, pressure, soreness, and/or a decrease in vision.” – Marie Huegel, OD, “Understanding the TED Diagnosis.”