Blog post first posted on the DHF blog, Nov 19, 2014.
Last month, I had one of the most amazing experiences I have had with technology since I have been living with diabetes. It happened at the Focus On Technology conference organized by Children With Diabetes in Los Angeles (the first time they do this mini-Friends For Life in the west coast), which was a resounding success with 300+ attendees. My experience wasn’t with CGMs, insulin pumps, or some of the other devices available today for day-to-day diabetes management. I had the opportunity to have the most in-depth retinal screening I have ever had, conducted by a group of students of Dr. Ben Szirth (a true legend in diabetic retinopathy, and one of the world’s foremost authorities on the topic), which concluded with a detailed review of the results with Dr. Ben himself.
He and his team work tirelessly to make software along with manufacturers that will catch eye complications earlier and help manage them before they get more serious. The machines, one of which speaks (giving you instructions to open/close your eyes, blink, etc.) not only do away with the need to dilate your pupils, but also allow them to collect data that is simply invisible unless you view it in a certain way. For instance, one of the machines takes multiples photos of the retina, in layer fashion, allowing them to conduct the equivalent to a histology of the retina, but without having to slice your eye (which of course we patients appreciate!) Here you can see me with one of the medical students by the talking machine:
Dr. Ben has pioneered a lot of this technology, working with his Medical Students at the NJ Medical School, and with engineers from the companies that make the equipment, effectively pushing the technology well past the point that many of them believed to be possible. He tries to convey to manufacturers the importance of tools that will see the invisible. One of the most fascinating observations he is able to conduct is the result of a very intense flash from a Canon device that leaves your retina a bit groggy for a few moments (again, without any pupil dilation). It takes a B&W picture of the retina, which allows the visualization of micro-aneurysms typical of mild proliferative retinopathy. These are impossible to see in the color photos, but appear clearly when you take the photo using the higher intensity flash. You can see what I mean below, where the color and B&W photos of the same eye are shown.
The bad news is that these are photos of one of my eyes. So I caught a glimpse into the future, as unprepared for it as I may have been, because this photo tells him what is going to happen. Dr. Ben said: “This is trying to be a bleeder. The more you do the ‘right thing’, this will disappear within six months.” The good news is I have the information to lower the risk of this blood vessel rupturing, potentially leading to a progression in retinopathy, by exercising more (to increase my Time in Range, doing a Big Blue Test or more every day) and drinking loads of water every morning (as Dr. Szirth recommended). I admit the news made me feel as shocked as I felt back when I got my diabetes diagnosis, back in 2002. It is unfortunately no surprise that this is happening now, since the past few months my diabetes management has not been the best, but it gives me an increased motivation to make sure I do all I can.