Dr. Ciano’s Interview With Indianapolis Star

Dr. Jeremy Ciano, an optometrist with RevolutionEyes in Carmel, discusses diabetic retinopathy with the Indianapolis Star.

Question: How common is diabetic retinopathy?
Answer: It’s the No. 1 cause of preventable blindness in the United States. (According to the
American Diabetes Association, 12,000 to 24,000 new cases of blindness due to diabetes occur
each year. Diabetes causes about 8 percent of the cases of legal blindness in the United States.)
Diabetes affects the small blood vessels of the body, and the eye is the only place in the human
body where we can see the blood vessels in a natural state without doing an invasive procedure.
Sometimes there are tiny blood vessels that have leaks, called a dot-and-blot hemorrhage. If we
see a dot-and-blot hemorrhage, we know the sugar levels are not under control.

Q: Will patients realize this?
A: They’re usually unaware of it first. They may have some blurred vision, but the first signs of
diabetic retinopathy can be undetectable to patients.

Q: How often should diabetics have their eyes checked?
A: At least every 12 months unless there’s a problem, and then it’s more often.

Q: How do you treat retinopathy when it occurs?
A: Sugar control is the main thing. Without a doubt, most of the time with good consistent blood
sugar control, the body can eat up that blood in about 90 days. If the patient develops a macular
edema, where they lose some vision or feel like they’re looking through water, then we use a
laser to treat that.

Q: How do you examine the eye?
A: The standard of care is to dilate the patient’s eye. We now have an instrument called the
Otomap that gives me the same view without having to dilate the patient. There’s less than 2,000
of these computers worldwide, and we were (number) 332.
Instead of having to put drops in and ruin their vision all day long, the Otomap takes a digital,
instant picture, and I can go over it in the office with the patient.

Q: Do leaks in the eye suggest something may be awry elsewhere?
A: The eye is the window to the soul. . . The only place in the human body where we see vessels
in their natural state is in the eye. If those tiny blood vessels are leaking blood in the eye, that
same pathology is occurring elsewhere in their body, in their heart, kidney, toes. We feel that the
health of the eye is more important than the vision. We want you to see well, but we want you to
be healthy first.