Page 47 - Demo

Moderate nonproliferative retinopathy: This stage is when blood vessels that nourish the retina are blocked.
Severe nonproliferative retinopathy: In this stage, many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
Advanced proliferative retinopathy: At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that lls the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result. Early diabetic retinopathy is asymptomatic. Once diagnosed with diabetes, patients should consult an eye doctor to have a thorough baseline assessment of their eyes. Regular follow-up eye examinations are essential every six months to one year, depending on the severity of the diabetic eye disease.
Wireless powered smart contact lenses that can diagnose and treat diabetes by controlling drug delivery with electrical signals are under development. Counter to past recommendations, there is general agreement amongst doctors that diabetic patients can wear contact lenses if extra precautions are taken. Those patients presenting with A1C levels of 10 and up are prohibited from wearing contacts. With a more modest elevation of 7 to 8, patients can proceed with contact use but should proceed with caution. Daily wear contacts should be used, and they must be thoroughly cleaned with the proper solution daily. Proper cleaning is vital to avoid particles attached to the lens causing abrasions or damage to the cornea. The risk for diabetics with contact use are corneal erosions. All eye injuries take longer to heal for a diabetic and therefore should be rigorously avoided. Dry eye is a high risk for diabetic patients, and they should be on the lookout for burning, itchy, gritty feeling or the sensation of something being in the eye. Always seek expert medical advice before starting contact lens wear. New therapeutic contact lenses measure blood glucose levels.
TESTS FOR THE ADULT EYE
A comprehensive examination by the doctor should include a dilated examination, screens for glaucoma, diabetic retinopathy, hypertensive retinopathy, macular degeneration and cataracts. It should also include taking visual elds, corneal topography (mapping), a scanner laser exam which aids in early glaucoma diagnosis, and digital photography to ensure there is a baseline image to aid in any further investigation of ocular disease. There are several additional tests, which might be done for contact lens wearers such as a Schirmer’s Test. This test measures tear production. Fluorescein staining analyzes the t of a contact lens or can highlight a scratched cornea. For the older patient, many of these tests are done on a routine basis to ensure optimal optical health as some diseases have little or no symptoms, and early treatment is best to halt any advancement.
Pachymetry: A pachymeter measures corneal thickness and is a useful tool for the diagnosis of corneal disease, glaucoma risk and for assessment of potential Lasik patients.
Visual elds: Contributes to the diagnosis of optic nerve disease and retinal pathology. Digital photography: Captures a baseline retinal photograph for comparison at subsequent visits.
CURRENT OR POTENTIAL CONTACT LENS WEARERS
The following tests might also be added:
Topography: Corneal topography, also known as photokeratoscopy or videokeratography, is a non- invasive medical imaging technique for mapping the surface curvature of the cornea. Since the cornea is normally responsible for 70 percent of the eye’s refractive power, its topography is of critical importance in determining the quality of vision. The three-dimensional map is therefore a valuable aid to the examining ophthalmologist or optometrist, and can assist in the diagnosis and treatment of a number of conditions; in planning refractive surgery such as Lasik and evaluation of its results; or in assessing the t of specialty contact lenses. A development of keratoscopy, corneal topography extends the measurement range from the four points a few millimeters apart that is offered by keratometry to a grid of thousands of
47 EYEZONE Issue 91-92 May / August 2020