Dealing with Diabetes-Related Vision Loss? Here's How to Maintain Independence
More than 100 million Americans live with diabetes or prediabetes. If you fall into that category (or know someone who does), you might be concerned about your eyesight: A type of vision loss known as diabetic macular edema, or DME, is a common complication of the disease. Losing your ability to see is a frightening idea, period. But so is the concept of depending on others when you’ve spent your whole adult life taking care of yourself. How will DME affect your independence? And how can you continue to live a full life, even with the disease? We’ve got the answers, here.
What Is DME?
Diabetic macular edema is a form of diabetic retinopathy, a disease that affects the retina—the light-sensitive tissue in the back of your eye. DME develops when blood vessels damaged by diabetes leak fluid and cause swelling in the macula, a part of the retina responsible for your central vision. Roughly half of patients with diabetic retinopathy will develop DME. The good news: Treatments for the disease are significantly better than they were a decade ago, says Thomas Gardner, M.D., professor of ophthalmology and visual sciences at the University of Michigan.
If I Have DME, Will I Go Blind?
The short answer is (almost certainly) no. “DME requires proper screening and diagnosis. But especially when caught early, this is a highly treatable condition,” says Ian Han, M.D., assistant professor of ophthalmology and visual sciences at the University of Iowa. Still, worries about blindness are not completely unfounded: According to the American Journal of Managed Care, people with untreated diabetes are 25 times more likely than the general population to become blind. Your takeaway? Get regular checkups!
Are There Tools to Help Low Vision?
“There are many aids that can assist patients with vision loss due to DME,” says Dr. Han. A far-from-exhaustive list includes traditional (and still highly effective) magnifying glasses and large-print books and magazines, as well as closed circuit TV (CCTV) magnifiers, which use video cameras to project magnified images of sewing, crossword puzzles, cookbook pages, or other daily tasks on the screen. Most eye centers have “vision rehabilitation experts” who can walk you through the options available.
Will I Still Be Able to Drive?
You could just hang out and wait for the autonomous car revolution to finally arrive. In the meantime, though, it’s probably a good idea to figure out other means of transportation. It’s nowhere near as convenient, we know, but far safer than having an accident and winding up in the hospital (cheaper, too!). Most towns have public bus service. If your condition gets worse, you should also talk with your healthcare provider about transportation options for people with disabilities.
How Can I Grocery Shop if I Can’t See?
First off, it's likely you'll still be able to see food, but nuances in color and reading the labels could get tricky. One tip: Learn to judge the ripeness of a fruit or vegetable by its feel, not its color. Firm skin that slightly yields to pressure with your fingers is typically a good indication that produce is just-right-ripe. Reading small-print labels in the store may be hard—try planning in advance by looking up the foods you want to buy on the USDA’s website, where you can magnify your screen to get nutritional info at a readable size.
Are There Ways to Make Daily Tasks Easier?
Yes! Smart technology is your new BFF. Need to dim or turn up the lights? How about adjust the thermostat on a tiny screen you can’t read? Or maybe figure out where the play button is on your stereo? There’s an app for all that—and if you wire your house (or have someone wire it for you) to work with smart tech, suddenly, you have a live-in assistant whenever you need it.
Will I Have to Move?
Not necessarily. Make your home easier to navigate with these strategies: Paint the frames around your doors a contrasting color to the walls—entryways can blur with DME but this trick helps your eye spot them. Similarly, choose a darker or lighter color for your stair railings, and clear hallways of any cords or clutter that you might trip over. Organization is key when you have DME: Designate a centrally located dropbox where small everyday items like keys are stored (a good tip regardless, since let’s face it: Losing your keys isn’t unique to DME!).
Will I Need Help Dressing?
If you’re concerned with the mundane duties of everyday life, like finding a shirt that goes with your pants, and socks that match, you're not alone. As your vision gets worse, use these hacks to help make sure getting dressed in the morning goes smoothly: Ask your dry cleaner to group same-color clothes together in the return bag; or ask a friend to help you arrange your closet by color, using tabs on the hang bar to denote a change. And take the guessing at subtle patterns out of the sock question by buying multiples of the same style.
Can I Still Do My Own Makeup?
DME makes it difficult to see your face clearly in the mirror—a necessity for applying makeup and brushing your hair. A magnifying mirror might help, but it’s no use if your vision is blurry. Instead, try making the swap from cosmetic brushes to your own fingertips when applying base, blush, and eyeshadow. You’ll be surprised at how accurate your sense of touch is—we can forget that, sometimes, in our vision-driven world.
How Do I Shave?
When you think about it, shaving is mostly tactile, not visual. Let your skin tell you where the razor needs to go (and run your fingers over your cheeks and chin once you’ve finished to feel for any rough patches you missed). Don't stress about whether an electric razor or safety razor is “better” for people with low vision. Use whatever type of razor you’re familiar with; just be certain that you replace the blades frequently, if using a safety razor (sharper is better) and clean the head of an electric razor regularly.
What If I Embarrass Myself When I Go Out?
The simple pleasure of eating out with family or friends can be an ordeal if you can’t read the menu or see your glass of wine. You’re not alone in this frustration, which is why many restaurants also offer large-print menus (just ask). You can also use the placemat to keep track of utensils, as if they're on a grid. When appropriate, finger foods and sandwiches might be easier to navigate. At home, place tactile stickers on similarly shaped containers (salt and pepper, for example) to help distinguish them.
Remember: Early Detection Is Key
“Health surveys tell us that people would rather lose a limb than their eyesight,” says Dr. Han. “But I’ve met plenty of patients who are so scared to find out they have diabetes that they won’t come in for an eye evaluation.” It can’t be stated often enough: The best way to increase your chances of living a full, independent life with DME and other forms of diabetic retinopathy, is to see an eye doctor on a regular basis—even when your sight appears to be perfectly fine.
Diabetes Prevalence: Centers for Disease Control and Prevention. "National Diabetes Statistics Report, 2017." cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
DME and Blindness: American Journal of Managed Care. (2016). “Overview of Diabetic Macular Edema.” ajmc.com/journals/supplement/2016/improving-outcomes-in-diabetic-macular-edema-the-impact-of-new-therapies-in-managed-care/overview-of-diabetic-macular-edema?p=1
DME and Anti-VEGF Injections: American Academy of Ophthalmology. "Anti-VEGF Treatments." aao.org/eye-health/drugs/anti-vegf-treatments
DME and Grooming, Eating, Etc: MD Support. (n.d.) “A Self-Help Guide to Non-Visual Skills.” mdsupport.org/guide.pdf