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Nurses and Eye Doctors: Teaming Up to Treat the Whole Patient
by Dr. Roger H. Phelps, O.D., F.A.A.O., C.D.E. Minority Nurse Writer
According to the 2011 National Diabetes Fact Sheet from the Centers for Disease Control, 25.8 million Americans currently have diabetes. Seven million of those cases go undiagnosed. Perhaps more troubling, in the black community, 4.9 million, or 18.7%, of all non-Hispanic blacks aged 20 years or older currently have diabetes.
These numbers are staggering, but one way to combat them is through preventive treatment and early detection. Both practices are critical, and early diabetes detection offers several benefits. If the disease is treated in the early onset stages, it can lead to a longer and better quality of life as well as lowered medical costs for the patient.
Nurses and optometrists are joined in their mission to provide the best quality care for their patients; by improving the lines of communication, particularly when treating patients with diabetes, they have a ready ally in achieving that goal. Here are some ways nurses and eye doctors can work together to improve a diabetic patient's quality of life.
The role of the eye doctor
Studies show patients are three times more likely to visit their eye doctor than their general physicians. At an annual eye exam, optometrists do much more than just check for changes in prescription. They conduct a comprehensive evaluation of the eyes and visual system, and are often the first people to see the signs of potential long-term health problems as well as spot new cases of chronic conditions like diabetes.
Through a dilated eye exam, optometrists can detect signs of chronic health conditions, including diabetes, high cholesterol, and high blood pressure. Those with diabetes are also at a higher risk of having cataracts and glaucoma. The eyes are the only places in the body where an unobstructed, noninvasive view of small blood vessels is possible.
If a chronic disease such as diabetes is detected, eye doctors generally report back to the patient's primary care physician and nurse and work with them to make sure they conduct the necessary follow-up and preventive care. This open communication link between optometrist, doctor, and nurse can work to the ultimate benefit for the patient.
Technological advances in the eye care field have also allowed for many sub-specialties of eye care professionals, as well as the development of non-invasive imaging (Ocular Coherence Tomography, or “OCT”), which allows doctors to look at details and measure changes within the retina down to a few microns. These advances are breeding new types of treatments for conditions like diabetic retinopathy.
Bridging the gap
Whether a patient has diabetes, is at risk, or is completely healthy, proper optometric care should be an important part of their health plan. Building bridges of understanding and communication between nurses, optometrists, and even family members ultimately fosters good patient care.
Patients should see their optometrist or general ophthalmologist for regular dilated eye examinations. If nurses find their patients are not going to the eye doctor, they should speak with them about the benefits. Again, even healthy, non-diabetic patients should receive an annual eye exam.
If the patient is diagnosed with diabetes, eye exams are a critical component of their overall care. An eye doctor will check for and monitor diabetic retinopathy, which is a leading cause of blindness. Also, the optometrist should know the patient's level of diabetic control (A1C history) when they examine the patient.
Nurses and physicians should know their patient's level of eye disease, if any, as they evaluate the patient. This will assist in the medical decision process as they consider the need for more aggressive control. Good A1C levels and a stable retina can be comforting to both the nurse educator and the patient in dealing with diabetes.
Maintaining an open communication channel between eye doctors, nurses, and physicians is vital to overall patient care, especially when working with those who have diabetes. There are a number of things nurses and optometrists can do to foster a more open relationship in treating the whole patient. Nurses could invite a panel of local eye doctors to a special association meeting for a discussion on diabetes. Likewise, optometric associations could invite a panel of diabetes nurse educators or other medical professionals to discuss the ongoing care of patients with diabetes. Even though a short, educational presentation could be beneficial in these meetings, one of the purposes would be to actually get to know each other and establish personal communication links between the professionals.
The importance of comprehensive eye exams in the early detection and ongoing management of diabetes cannot be overstated. It is no longer enough to simply know that you have diabetes; you need to understand how it affects your entire body and impacts your overall health. From the eye doctor to the dentist to the general practitioner, health care providers all have to work together to help the patient understand the ramifications of the disease. Getting a head start on diabetes through an annual comprehensive eye examination can help reduce diabetes-related damage to the body and prevent a variety of accompanying problems, which will help the patient lead a happy, healthy, and fulfilling life.