How an eye exam could save your life

VSP Real World Solution Series

A routine eye exam has the potential to detect life-threatening, chronic diseases early on—but only if patients make sure to keep going in regularly.

One of the most frightening aspects of type 2 diabetes—the third leading cause of death in the country—is that it’s hard to catch early on. The symptoms of prediabetes, like thirst, fatigue, darkened patches of skin, are so innocuous that they alone aren’t likely to compel someone to visit the doctor.

And when prediabetes evolves into full-blown diabetes, as it does for roughly one in eleven Americans, patients are at increased risk of heart disease, stroke, vision loss, and the loss of limbs. But even worse, some 8.1 million people are walking around undiagnosed, untreated, and unmonitored. To get ahead of this mounting health crisis, early diagnosis and intervention are key to warding off serious and life-threatening complications.

Unfortunately, as many as 1 out of 3 patients in high deductible health plans are likely to avoid going to the doctor even for routine check-ins, largely because they are unaware that preventive care is free or low-cost. They may also be unaware that help can come from an unexpected source: Optometrists are uniquely positioned to detect diabetes in its beginning phases, when it can still be managed and its impacts lessened. Our eyes are windows into our bodies too, it turns out, reflecting deeper health problems that all too often go unnoticed.

How exactly do eye doctors spot diabetes before patients can tell they have it? By dilating the pupils, optometrists have a unique and unobstructed view of the tiny, fragile blood vessels that feed the retina on the back of the eye. Diabetes causes spikes in blood sugar that weaken and damage blood vessels over time, a symptom that often shows up first in the swelling, leaking, and bleeding of capillaries in the retina. The damage accumulates over time and can lead to loss of vision.

Those miniscule but significant changes can be detected in a noninvasive eye exam years before other signs of diabetes finally drive someone to see a doctor, by which time the disease can be advanced and treatment options much more limited (and expensive). A 2013 study conducted by the Human Capital Management Services Group on behalf of VSP Vision Care confirmed what optometrists have known for a long while. The study found that in 34 percent of diabetes cases, VSP network doctors were the first to detect early signs of the disease (before primary physicians or different specialists). What’s more, VSP vision plans were found to produce savings of “up to $2,787 per employee over two years” as a result of lower health-care costs and improved employee productivity.

Even in patients already diagnosed with diabetes, annual eye exams are enormously important to preventing blindness. As the American Diabetic Association website notes, the sooner diabetic retinopathy is diagnosed, the more likely treatment will be successful. “Retinopathy in the advanced stages is one of the leading causes of preventable blindness,” explains Dr. Justin Bazan, a VSP network eye doctor and medical advisor to The Vision Council. “And that is an important term. ‘Preventable’ means that if you had tighter control of the disease you wouldn’t end up with total vision loss.”

Patients are more likely to visit an optometrist than their primary care doctor, since eye exams are relatively brief and non-invasive. “When people have vision benefits, they want to use them. It’s one of the most utilized health benefits,” explains Bazan. And employers offering vision benefits from VSP had a 23 percent higher enrollment rate than other vision plans. Simple services, like the exam reminder letters that VSP mails to patients with diabetes, can help increase the number of patients who return to their providers for follow-up exams. Partly because of considerations like that, VSP’s plans make eye exams up to six times more accessible to more people.

But it all starts with the pivotal understanding that the eyes can tell us more than what they see, serving as a strong indicator of overall health. “People should go to the eye doctor every year to make sure everything is in good shape,” explains Bazan. “There’s a close connection between ocular health and general health. Our eyes are windows to our entire vascular and nervous system.”

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