What Is Teleophthalmology?
Teleophthalmology allows patients with diabetes to receive screening for Diabetic Retinopathy by an Ophthamologist who may be miles away. The Round Valley Indian Health Center (Health Center) has been providing Teleophthalmology screening services for patients with diabetes since October of 2001. We acquired a camera with the capability to capture a high-resolution image of the eye's retina. Images are stored on a computer and then sent via email to Dr. Mason who is 60 miles away. This process is known as "store and forward". Dr. Mason has a similar computer and is able view these images and he screens them for pathology. If something abnormal is noted, patients are referred for an in-person visit with an ophthalmologist. Because these images are stored, the ophthalmologist will always have a baseline picture to compare with future images. This can help to track progression or stop the disease process.

What is Diabetic Retinopathy?
It is well documented that people with diabetes are at a higher risk for acquiring Retinopathy. Retinopathy means disease of the retina of the eye. The retina is the membrane that lines the inside of the eye it has blood vessels feeding it nutrients and oxygen. The optic nerve also resides in the membrane; it is able to gather light and send images to your brain. Diabetes affects all blood vessels in your body including those feeding you retina. Over time high blood sugars can damage your blood vessels by creating plaques that can encourage clots or cause your vessels to become brittle and break. If vessels break in the retina, bleeding can occur. Bleeding in the area of the macula can lead to blindness. Clots can lead to decreased blood flow which then causes more blood vessels to grow in the area of the macula and this can also lead to blindness.

Can Diabetic Retinopathy be prevented in people with diabetes?
The most effective way to prevent the occurrence or reduce the severity of diabetic retinopathy is for people with diabetes to maintain glycemic (blood sugar) control. Hemoglobin A1c (A1C) is the "gold standard" for assessing glucose control. This test should be conducted at three to four month intervals. Lowering A1C has been associated with a reduction in micro-vascular and neuropathic complications of diabetes like Diabetic Retinopathy. A1C estimates the average degree of glycemic control over the preceding three months. A1C is the standard way to measure glycemic control. Controlling blood pressure can also be effective. Visiting your doctor every three months is highly recommended until you get your diabetes under control.

What if I already have Diabetic Retinopathy, is it too late?
If you already have been diagnosed with Diabetic Retinopathy, it is not too late! There things you can do to prevent or slow further damage. Diet, exercise and appropriate medication management is your best defense against any further damage to your eyes. Quarterly visits to your doctor will be necessary until you get your diabetes under control. If your eye sight is being affected, it is still not too late! Laser surgery can save vision and prevent further damage.

For an eye care screening you will first need to see your Health Center physician.