Ophthalmologists must take active role in diabetic patient behavior modification

NUSA DUA, Indonesia — Ophthalmologists must be proactive in the modification of their diabetic patients' behavior to prevent unnecessary vision loss, a speaker said here.

Ian Constable

"The eyes are a very good way of getting somebody to change their lifestyle. If someone has diabetic retinopathy, you show them the photographs; you say you'll go blind if you don't change. They will change for that," Ian Constable, AO, MBBS, FRACS, FRACO, FRCS(ED), said during the joint meeting of the Asia-Pacific Academy of Ophthalmology and American Academy of Ophthalmology here in Bali. "It's important that you become part of that change in their lifestyle."

In the Academia Ophthalmologica Internationalis Lecture, Dr. Constable explained that there is a pandemic of diabetes across the globe, "the biggest epidemic in human history."

Within this pandemic, he explained that one-third of the now 250 million diabetic patients will suffer from diabetic retinopathy, but that 90% of severe visual loss can be prevented by treatment and, more importantly, behavior modification in the "prediabetes" sector of patients.

By explaining to them the risk of visual loss they incur is very great, ophthalmologists have the ability to impact patient behavior from diet to exercise.

"If you can get your patients to eat the right white rice, you're doing them a big favor, just as much as you are by giving them a pair of glasses or laser," Dr. Constable said.

In addition, he said ophthalmologists must make the effort to see all diabetic patients at least every 2 years and photograph the eye as even trained ophthalmologists can miss diabetic retinopathy in 5% to 10% of cases that they do not photograph.

"Establish glucose, blood pressure and lipid control. Don't just laser this patient and say it's someone else's problem to get them to change their lifestyle," Dr. Constable said. "Influence their diet and exercise."