The Eyes Can Reveal This Silent Killer:

Save your vision by having a yearly eye exam

Eye exams can help in the diagnosis of diabetes, a leading cause of blindness and vision loss. Here, Emil Say, M.D., a retina specialist at MUSC Health Storm Eye Institute, talks about the importance of comprehensive, routine eye exams for early detection and treatment of diabetes to reduce complications, including vision loss. 

Regular eye exams can provide clues to your overall health. That’s because the condition of blood vessels in your eye can indicate the health of other blood vessels in your body. Eye exams can help in the diagnosis of diabetes, hypertension, rheumatoid arthritis, multiple sclerosis and cancer.

Diabetes, for example, has no obvious signs or symptoms. It’s a leading cause of blindness and vision loss in people 18 to 64 years old. In South Carolina, one in seven adults, or approximately 500,000 adults, has diabetes. But because the signs of diabetes are so easy to miss, people can have the condition for years without knowing.

“Some patients don’t realize the impact of diabetes until they get a complication of the eye,” says Dr. Say, of MUSC Health Storm Eye Institute. “Then they often have only a few options to save their vision.”

Diabetic retinopathy

As a member of the Storm Eye team, Dr. Say focuses on pediatric and adult retinal diseases and provides expert, specialized care for a broad range of rare and complex retina conditions. The retina is made up of light-sensitive tissue positioned in the back of the eye. It sends images to your brain to help you see.

One of the conditions Dr. Say specializes in is diabetic retinopathy, a common complication caused by diabetes. Diabetic retinopathy happens when high blood sugar levels from diabetes cause blood vessels in the retina to swell and damage the retina.

Diabetic retinopathy is the leading cause of blindness in American adults, but with early detection and treatment, vision loss can be reduced significantly. Comprehensive, routine eye exams can help detect diabetic retinopathy in the early stages and reduce the risk of progression in a significant number of cases.

“The exam must include dilation of the eye,” says Dr. Say. “The retina is behind the pupil, so it can’t be examined well unless you dilate the pupils or take specialized imaging. That’s why an annual dilated eye exam is so important to protect your eyesight, especially if you have diabetes.”

Defeating the silent killer

During a dilated exam, eye drops help make the pupils larger so the doctor can see a larger portion of the retina. At MUSC, the Diabetic Retinopathy Telemedicine Screening program uses a specialized camera to take and record detailed images of the retina.

Dr. Say has found these images are powerful, tangible evidence of the progression of diabetes. “For many patients, these images are proof that their eye disease is getting worse without them knowing, and that’s when they understand that diabetes can be a silent killer,” he says. “They realize the condition is not in good control. Even if they don’t feel a difference, the photos of their eyes show them diabetes is a real problem, and it’s time to take action.

“And it motivates patients to get their A1C levels to a healthy level,” he continues.

Young patients, in particular, respond with heightened awareness. “I see a change in their approach to diabetes, and in how they see themselves,” says Dr. Say. “They understand it’s getting worse and are ready to partner with their primary care physician or endocrinologist to treat their diabetes and avoid further complications.”

These patients are able to change their habits and lifestyles to help keep diabetes in control. “They turn things around and are able to live fuller, healthier lives because of early detection, thanks to a dilated eye exam,” says Dr. Say.

Signs and symptoms

Diabetic eye diseases often have no signs or symptoms. Talk to your doctor if you have:

• Blurred vision
• Dark spots or "holes"
• Flashes of light
• An increase in the number of floaters
• Poor night vision

When to have a dilated eye exam

General guidelines:

• People with diabetes should have a dilated eye exam every year.
• Adults older than 60 (Blacks and Hispanics, older than 40) should have a dilated eye exam every year or two.
• People with a family history of glaucoma should have a dilated eye exam every two years.

Call 843-792-2020 to schedule an in-person or virtual visit. You can learn more at MUSC Health Storm Eye Institute.