Please read this article to discover what diabetic retinopathy is and what Medicare covers. You will learn the following:
Estimated reading time: 6 minutes
Medicare and Diabetic Retinopathy
If you have diabetes, Medicare Part B covers eye exams for diabetic retinopathy. Medicare will cover a state-licensed eye doctor to test your eyes once a year. After you pay Part B deductible, Medicare will pay 80% of the eye exam costs. Thus, you pay 20% with Original Medicare.
However, some Medicare Supplement plans cover your 20% Part B coinsurance. Furthermore, Medigap plans also cover copayments for eye exams in a hospital outpatient setting. Please call Senior Healthcare Direct at 1-855-368-4717 to shop for Medigap Plans.
What is Diabetic Retinopathy?
Diabetic retinopathy is an eye disease that causes vision loss and blindness in people who have diabetes. High blood sugar levels cause damage to blood vessels in your retina. For example, blood vessels in your retina can swell, leak, or close. Furthermore, abnormal new blood vessels can grow on the retina. Any of these changes can cause vision loss. (AAO.org)
This diabetic eye disease has the following two stages:
Two Stages of Diabetic Eye Disease
Two stages of diabetic eye disease are early-stage NPDR and advanced stage PDR.
Early Stage NPDR
The early stage of diabetic eye disease is Non-Proliferative Diabetic Retinopathy (NPDR). During NPDR, blood vessels leak fluid, making your macula (center of your retina) swell. Vision loss from early-stage diabetic retinopathy is similar to age-related dry macular degeneration.
Furthermore, blood vessels in the retina can close off with NPDR, causing macular ischemia. Consequently, this results in extensive damage to the retina and vision loss. (NIH.gov)
Moreover, sometimes deposits of fats can leak into your retina. These deposits are called hard exudates. People with Diabetes who have NPDR will have blurry vision.
Advanced Stage PDR
Proliferative Diabetic Retinopathy (PDR) is the advanced stage of diabetic eye disease. When many retinal blood vessels close, your retina does not get adequate blood flow. Consequently, your retina responds by growing new blood vessels, neovascularization.
As a result, these fragile new vessels often bleed. If vessels bleed a little, you see a few dark floaters. If vessels bleed a lot, you may lose your vision.
PDR can form scar tissue and cause problems with your macula (center of the retina). Complications may include a detached retina and glaucoma. PDR is a severe diabetic eye disease and can cause you to lose central and peripheral vision.
Now that you know the two stages of diabetic retinopathy, what are the symptoms?
Diabetic Retinopathy Risk Factors
Anyone with diabetes, including type 1, type 2, and gestational (pregnancy) diabetes, can get diabetic retinopathy. Furthermore, your risk increases the longer you have diabetes. However, you can lower your risk by controlling your diabetes. (MayoClinic.org)
The risk for developing diabetic eye disease increases as a result of:
- Poor control of your blood sugar level
- High blood pressure and cholesterol
- Tobacco use
Furthermore, people at higher risk include African-Americans, Hispanics, and Native Americans. Females can also be at higher risk during pregnancy.
Now that you know the risk factors, what can you do to prevent this eye disease?
Preventing Diabetic Retinopathy
Dr. Robert Lustig, M.D. and nutrition expert, says sugary drinks increase your risk for type 2 diabetes. Robert explains the scientific evidence in his video, The Bitter Truth. He recommends you eliminate all sugared liquids, including alcoholic beverages, and drink only water and milk.
Medicare Diabetes Prevention Program helps you with behavior changes to prevent type 2 diabetes. Discover what Medicare covers for Diabetes.
Regular annual eye exams can diagnose eye diseases early so that you can start treatment before severe vision loss. Furthermore, please keep your medical conditions under control:
- Manage Diabetes – if you have pre-diabetes, you can join a Medicare Diabetes Prevention program. If you have diabetes, please take your prescribed diabetes medications.
- Keep your blood pressure and cholesterol under control. Please eat healthy foods and exercise regularly. For example, eat more fruits and vegetables, and walk every day.
- If you smoke, Medicare can help you quit smoking.
You can not always prevent diabetic retinopathy. If you have this eye disease, what are your treatment options?
Your treatment options depend on whether you have early or advanced diabetic retinopathy. Furthermore, treatment will depend on the severity of your particular condition. (MayoClinic.org)
In the early stage, you may not need treatment. However, keeping your blood sugar under control can slow the progression of this diabetic eye disease.
For the advanced stage, you will need eye surgery immediately. Your surgical treatment options include:
- Focal laser treatment (photocoagulation) stops or slows the leakage of blood and fluid in your eye.
- Scatter laser treatment (panretinal photocoagulation) shrinks abnormal blood vessels.
- Vitrectomy removes blood from the middle of your eye as well as scar tissue on your retina.
- Injecting medication in your eye to help stop the growth of new blood vessels.
These surgical options slow or stop the progression of diabetic retinopathy. However, none of these treatments cure this diabetic eye disease.