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Guest Blog: Dr. Gerard Lozada

November 5, 2009

As a part of Diabetes Awareness Month I asked four people who I admire to write a blog post for me. I am so lucky that all of them said yes.

My first guest post is from my eye doctor. Dr. Lozada is the owner and optometrist at Rosedale Vision Center located at 3424 Rainbow Blvd., Kansas City, KS  66103. I love him because 1. He found Dre’s cataracts that Children Mercy had missed (that’s a whole other rant post) 2. He is friendly, nice, comforting, always happy and explains EVERYthing to me so that I can understand it 3. He is an advocate for good eye health 4. He remembers his patients when he sees them outside of the office 5. He is living his passion

Guest Post:

Remember that diabetes is a disease of metabolism in which the body is unable to properly control the amount of sugar in the bloodstream.  This is why blood sugar is measured and a higher number indicates a greater problem of control.  When too much sugar is available, vision can become blurry due to excess sugar in the eye itself.  This greater than normal amount of blood sugar causes a fluid in the eye (the vitreous fluid) to actually change the focus of the eyes. Some diabetic patients even report that their vision changes after eating a meal.  Fluctuating vision is often the first symptom that brings a diabetic patient to my office.  For a patient with this problem, I do not recommend that they obtain eye glasses until after their blood sugar is under stable because the eye glass prescription that I measure will depend upon their level of blood sugar at that moment.  In other words, it is possible to have a patient see clearly with one measurement when they are hungry and a different measurement after eating a meal.

 How clear a patient is able to see is not the only way that diabetes affects the eyes.  When too much sugar is present in the blood vessels, smaller blood vessels begin to leak.  Sometimes these small blood vessels leak a clear fluid, but if a patient has diabetes that is not controlled or is taking medications, but not under control for a long time, the leaks become big enough for blood cells to pass through.  The eyes and kidneys have some of the smallest blood vessels in the body and, as I like to tell patients, it is easier to see these hemorrhages inside the eye than inside the kidneys.  Some patients have no leaks at all inside their eyes and that is obviously the best outcome to have.  Some patients have small hemorrhages that quickly clear up one day with a new hemorrhage appearing in a different area the next day.  These patients have “Background Diabetic Retinopathy” and are the normal state for them.  Patients who do not have their disease controlled may have larger hemorrhages and even new blood vessels growing inside the eye.  These patients have “Proliferative Diabetic Retinopathy” which must be followed closely to prevent sight-threatening hemorrhages from occurring.

 If you are a diabetic patient, the level of care that is best is to have an eye examination every year with eye dilation.  Eye dilation simply provides the best view inside of the eye and getting a detailed view inside of the eye is the only way to know what is really happening.

 Dr. Gerard Lozada

Thank You Dr. Lozada for guest posting for me. It means more than words can ever express. Praying that you get more patients than you can handle.

Talk about it because Everyone Knows Someone!

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2 Comments leave one →
  1. November 5, 2009 4:38 pm

    Hi Ms. Bradley;

    Thank you so much for your kind words. Sometimes it is difficult to know if I am getting through to patients and so reading what you have written lets me know that the answer is YES! Getting a patient to understand and become proactive is key which is both good and bad.

    Those patients who want to be proactive, like yourself, are very much in tune that we both have the same goals. Other patients feel that the questions I ask are personal and so they leave the practice. Unfortunately the most obvious example is, believe it or not, diabetic patients. All diabetic patients will be asked their RBS, H1Ac, and permission to have their eyes dilated at every appointment. Some patients do not want for me to point out that they are not following their diet recommendations, not loosing weight (if that is needed), or that their blood sugar or H1Ac is too high and so they come once, maybe twice to my practice and leave to find a different doctor who does not ask these questions. I hope that your readers learn about retinopathy and the importance of eye dilation so that they can ask themselves if they are getting the standard of care that all diabetic patients should be receiving. All the best to you and your boys.

    drl

  2. November 10, 2009 9:12 am

    Andrea-

    great post! We need more Doc’s like this in the Diabetes Community

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