Eye Exams, Timely Treatment Can Save Your Sight: One Woman’s Story

A story on the National Eye Institute's (NEI) website illustrates how quickly a person’s vision can deteriorate when affected by diabetes.

The story belongs to Rosetta Ivey-Foster, a retired bank clerk who carefully managed type 1 diabetes for over 25 years. Her regimen included regular dilated eye exams to detect early symptoms of diabetic eye disease.

Just prior to Labor Day in 2015 Ivey-Foster noticed a floater in one eye that resembled a water bubble. She had floaters before that eventually disappeared, but this one persisted. Then, while attending a Labor Day air show Ivey-Foster realized she couldn’t see the planes.

Diabetes and Retinopathy

Though yet unaware, Ivey-Foster had symptoms of diabetic retinopathy, the most common cause of vision loss for people with diabetes, and the most frequent reason for blindness in working-age Americans. Retinopathy occurs when, over time, high blood sugar from type 1 or 2 diabetes damages tiny blood vessels in an eye’s retina.

Retinas detect light and transform it into signals that travel via the optic nerve to our brain. However, when damaged retinal blood vessels leak fluid or bleed, light detection and signaling become distorted.

Retinopathy may progress through four stages:

  1. Mild nonproliferative retinopathy is characterized by micro-aneurysms, or balloon-like swellings along retinal blood vessels that may eventually leak fluid.
  2. Moderate nonproliferative retinopathy occurs when entire blood vessels swell and become distorted; some may no longer be able to transport blood.
  3. Severe nonproliferative retinopathy is diagnosed when damaged blood vessels can no longer deliver a blood supply to sections of the retina. These sections begin secreting growth factors that "tell" the retina to grow new blood vessels.
  4. Proliferative diabetic retinopathy begins when new blood vessels, triggered by the secreted growth factors, grow inside the retinal surface. These new vessels are fragile, likely to leak, and accompanying scar tissue may contract and pull the retina off underlying tissue, causing vision loss.

At any stage of retinopathy DME, or diabetic macular edema may develop. DME is a buildup of fluid in the macula, an area of the retina responsible for clear straight-ahead vision. This is a common cause of vision impairment.

Saving Her Vision

Back at the Labor Day air show, Rosetta Ivey-Foster realized something was very wrong with her eyesight. She immediately contacted and visited her eye doctor, Suber Huang, M.D., founder of the Retina Center of Ohio. They discovered that Ivey-Foster could no longer read anything on an eye chart with her right eye owed to abnormal, leaky blood vessels growing on the retina’s surface.

Fortunately, prompt treatment restored most of Ivey-Foster’s sight. She underwent laser treatment to shrink the abnormal blood vessels, and a procedure - called a vitrectomy - to replace the bloody fluid in her eye with saline solution.

Ivey-Foster’s experience highlights the importance of getting regular eye exams, and illustrates how quickly symptoms of retinopathy can manifest and progress. Any changes we experience in our vision should prompt an immediate call to our eye doctor.

Stay On TRACK

For individuals with diabetes, the NEI’s National Eye Health Education Program suggests five essential steps to prevent or slow the progression of diabetes-related eye disease:

    T ake medications as prescribed.
    R each and maintain a healthy weight.
    A dd physical activity to daily routines.
    C ontrol the ABCs: A1C, blood pressure, and cholesterol.
    K ick the smoking habit.

Keeping our health on TRACK can also deter other diabetes complications such as cardiovascular disease, or peripheral neuropathy—and young people who get and stay on TRACK may never develop pre, or type 2 diabetes.

Sources: NEI/Story; NEI/Retinopathy
Photo credit: National Eye Institute, National Institutes of Health

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