Dr. Frank Spellman, M.D (Photos by Shantella Y. Sherman)
Diabetic retinopathy is the most common diabetic eye disease and the leading cause of blindness in adults 20 to 74 years of age. So why do so few African Americans know they are at risk for developing it and losing their sight? According to the National Eye Institute (NEI), more than 800,000 African Americans have diabetic retinopathy. And while fear of physicians, an “I’d rather not know” mentality, and a lack of access to resources, have all been blamed for its prevalence, those impacted by diabetic retinopathy is projected to increase to approximately 1.2 million people by 2030.
According to Dr. Frank Spellman, M.D., retina specialist with The Retina Group of Washington, who has been treating diabetic retinopathy for thirty years, awareness of the degenerative nature of the disease is key to stemming its progression.
“We cannot allow patients to be in denial about the impact of these kinds of diseases. We understand that people are busy and they are working to support their children and raise their families. You add to that a person with diabetes, who has an entire complex of other health concerns that can range from heart to vascular and kidney disease, and they simply do not have their eyes checked,” Spellman said.
Several eye diseases plague diabetics, including cataracts, glaucoma, and diabetic retinopathy, which is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, blood vessels may swell and leak fluid; while in others, abnormal new blood vessels grow on the surface of the retina.
Blood vessels damaged from diabetic retinopathy can cause vision loss when damaged blood vessels leak blood into the center of the eye, blurring vision. Fluid can also leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs, causing the macula to swell and blur vision. Known as macular edema, this can occur at any stage of diabetic retinopathy.
Spellman points to a set of twins, both with type 1 diabetes whom he treated several years ago. In what he documented as “A Tale of Two Sisters,” Spellman said that one was extremely compliant and went to her doctors’ visits and managed her diet; the other not.
“Her identical twin had a pathological fear of physicians and was to an extent was in denial about the potential ramifications of the disease she had. That sister died within several years of our first meeting. The identical twin, to my knowledge, is doing fine and seeing well, and under the care of one of my colleagues in Greenbelt. She is here functioning as a member of society and her sister is just a memory,” Spellman said.
The Diabetes Control and Complications Trial (DCCT) showed that better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery.
With advances in technology, Spellman believes more African Americans could potentially save their vision, if they managed their diabetes and ensured their eye health.
“We can help a much wider range of patients. We owe it to our community to give them the very best. We want people to protect their vision so that they are able to live productive and rewarding lives,” Spellman said.