One of the worst things that could happen to the millions of Americans with diabetes is losing their vision. Diabetic retinopathy is a serious problem that can happen with diabetes. It is the main cause of new cases of blindness in working-age adults in the United States. The scariest thing about this disease is that it is a "silent" thief; in its early, most treatable stages, it doesn't show any symptoms at all. To keep your eyesight safe, you need to work closely with your doctor and be on the lookout for problems. This is where the Direct Primary Care (DPC) model shines.
Diabetic retinopathy is a disease that happens when high blood sugar levels hurt the small, fragile blood vessels in the retina, which is the light-sensitive tissue at the back of your eye.
How it Takes Your Sight: There are two main ways that damaged blood vessels can make you lose your vision:
When they swell up and leak fluid into the center of your retina, it can cause blurry vision. This is called macular edema.
They can close up, which makes your eye grow new, weak blood vessels. These strange blood vessels can easily bleed into the eye or make scar tissue that makes the retina separate from the eye.
The "Quiet" Danger: Diabetic retinopathy doesn't hurt or change your vision in the beginning. You won't know you have it until you get a real eye exam with your eyes wide open. By the time symptoms show up, a lot of damage may have already been done that can't be fixed.
How to Save Your Sight: The American Diabetes Association says that the two best ways to keep your vision from getting worse are to:
Tightly control your blood sugar (glycemic control), blood pressure, and cholesterol.
Getting a full and dilated eye exam at least once a year to find the disease as soon as possible, when it is easiest to treat.
Direct Primary Care (DPC) is a membership-based model that lets patients see their doctor whenever they want. Your DPC doctor is your main point of contact and care coordinator, while an ophthalmologist or optometrist does your eye exam and any special treatments. Here are some reasons why DPC is the best way to protect your eyesight:
Aggressive management of systemic risk factors: This is the basis for prevention, and it's one of the DPC model's best features.
Tight control of blood sugar and blood pressure: Your DPC doctor has the time and availability to work closely with you. They can help you reach the strict blood sugar (A1c) and blood pressure goals that are known to stop retinopathy from getting worse by checking in with you often and talking to you all the time.
Comprehensive Cardiovascular Health: They will also help you control your cholesterol with statin therapy and give you useful advice on diet and exercise.
Making sure you never miss an eye exam that could save your life: This is where DPC fills in a big hole in the way healthcare is usually set up.
A System for Proactive Tracking: Your DPC practice knows that getting your eyes checked every year is an important part of taking care of your diabetes. They will keep track of when you are due and remind you ahead of time.
Referrals that work together: They can help you get a smooth referral to a trusted local eye care professional and will check in afterward to make sure the appointment went well and to go over the report.
Using modern technology: Teleretinal imaging is now being used by some DPC practices. This lets you get a high-resolution picture of your retinas right in the primary care office and send it electronically to an eye specialist for review. This makes it much easier for you to get this important screening.
A Partner Who Works Together for Your Overall Health: Your DPC doctor makes sure that all the parts of your healthcare puzzle fit together. They keep in touch with your eye doctor so that your eye health plan and your overall health plan are always in sync.
Case 1: David, 62, has type 2 diabetes and hasn't had an eye exam in four years because "his vision is fine." At his DPC annual wellness visit, his doctor talks to David about the serious risk of silent retinopathy and calls a local ophthalmologist's office to help him set up his overdue dilated exam. The test shows that David has moderate retinopathy that needs to be treated. This early detection saves his vision.
Case 2: Linda, who is 58 years old, has diabetes that is not well controlled. Her DPC doctor works with her a lot over the course of six months, with regular visits, to bring her A1c down from 9.2% to 7.1% and her blood pressure down to normal. Linda's ophthalmologist is happy to report that the mild retinopathy she had a year ago has not gotten worse at her next annual eye exam. This is because Linda did such a good job of controlling her overall health in her DPC partnership.
Q: My eyesight is fine. Do I really need to have my eyes checked every year? A: Yes, for sure. This is the most important thing to know about this illness. In the beginning, diabetic retinopathy doesn't show any signs. A lot of damage has already been done by the time it starts to hurt your vision, and it is often permanent. The yearly dilated eye exam is meant to find the disease before you have any symptoms, which is when treatment works best to protect your vision.
Q: Can my DPC doctor check my eyes for diabetes in their office? A: A qualified eye care professional, such as an ophthalmologist or an optometrist, must do a full, dilated eye exam to check for retinopathy. Your DPC doctor must make sure you get this test done every year without fail. They must also aggressively control the blood sugar and blood pressure that cause the disease in the first place.
Q: Can diabetes really cause vision loss? A: Yes, to a very large extent. It is thought that keeping blood sugar and blood pressure under tight control and getting regular, timely eye exams to find and treat problems early can lower the risk of severe vision loss from diabetes by more than 90%.
DPC has a clear advantage when it comes to protecting your eyesight from the effects of diabetes because it
Doing a great job of preventing problems through systemic control: The DPC model is the best way to keep blood sugar, blood pressure, and cholesterol levels in check, which is the key to stopping retinopathy.
Filling in the "Screening Gap": DPC's proactive, long-term approach makes sure that you get your important, vision-saving annual dilated eye exam every year.
Giving coordinated care for the whole person: As the main link between you and your eye doctor, making sure that all of your health needs are met in a way that works well.
Diabetic retinopathy is a thief of sight that doesn't make any noise, but you can fight back against it with a medical partner who is always on the lookout. Controlling your diabetes and getting your yearly screenings without fail are two things you can do to protect your vision. You need a long-term, personalized, and all-encompassing partnership to protect your vision for the rest of your life. Direct Primary Care can help you with that.
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