What is the Pupillary Distance and what does that have to do with your  Diabetes Vision you ask?

Well let me put it this way, there is a ruckus going on around the prescription eye glass world today on one very hot button  issue that I will touch on in a second and you know something is a hot button issue when there is an online petition trying to change the status quo.

Lets first begin with  this diabetic complication aptly named  the diabetes vision or diabetic retinopathy.

This is a condition that is characterized by damage to the eye retina, causing vision loss, it is one of the main causes of visual loss in diabetics aged 20-64 years old. It is caused by long term exposure to high blood glucose commonly found in both type 1 and type 2 diabetes.
Diabetes Vision – symptoms

usually they will be no symptoms until the damage to the eyes is advanced and severe.

Any symptoms for this diabetes vision will include but not limited to.

• Difficulty seeing at night
• Floating areas in your eyes
• Shadows in your vision
• Blind spots

Diabetes Vision – Risk Factors

The following Risk factors have been identified as directly responsible for the severity of DV in most patients.

• Years since DV diagnosis
• hypertension
• HbA1c levels
• Male sex
• Age seems to reflect a confounding association as well.

Diabetes Vision – treatments

Usually treatment will not  reverse damage that has already occurred, but it can curb the spread of the disease.

Treatment will be needed however if  new blood vessels are growing in your retina (neovascularization) or if you develop macular edema.

Treatment usually takes the form of surgery with 2 main procedures

1. Laser eye surgery – Eye surgery, also known as orogolomistician surgery or ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist.

1. Vitrectomy- this is a a surgery to remove some or all of the vitreous humor from the eye. Anterior vitrectomy entails removing small portions of the vitreous from the front structures of the eye – often because these are tangled in an intraocular lens or other structures. Pars plana vitrectomy is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous – the eye’s clear internal jelly.(Wikipedia)

Diabetes Vision – Types and progression.

There are two types, or stages of DV

• Non-proliferative DV will develop first. Blood vessels in the eye become larger in certain spots (called microaneurysms). Blood vessels may also become blocked. There may be small amounts of bleeding (retinal hemorrhages), and fluid may leak into the retina. This can lead to noticeable problems with your eyesight.
• Proliferative retinopathy is the more advanced and severe form of the disease. New blood vessels start to grow in the eye. These new vessels are fragile and can bleed (hemorrhage). Small scars develop, both on the retina and in other parts of the eye (the vitreous). The end result is vision loss, as well as other problems.(Google health)

Diabetes Vision – Testing

Testing to diagnose DV will be done by dilating the pupils with eye drops and then carefully examining the retina.

A retinal photography or fluorescein angiography test may also be used to diagnose this disease.

Diabetes Vision- Prevention

Preventing DV requires a complete control on blood glucose levels and if you are a smoker, quitting smoking will help as well.

As a diabetic, it is recommended that you have your eyes tested by an ophthalmologist at least once a year.

Most of the time you will be required to wear corrective lenses to improve your eyesight.

Diabetes Vision and the Pupillary Distance

Pupillary Distance or PD is the distance between your pupils, its measurement  ensures the correct centration of your Prescription lenses in front of your eyes.

The most common method used to measure the PD involves a simple millimeter ruler.  Normally the Optician holds the ruler between thumb and forefinger and steadies his hand by placing his remaining three fingers against the patient’s head. The Optician then closes his right eye. The patient is instructed to look at the opticians open left eye while the optician lines up the zero mark on the ruler with the edge of the iris in the patients right eye. The optician then closes his left eye and opens his right eye and instructs the patient to look at the open right eye. The PD is then measured at the edge of the Iris in the patients left eye.(thanks to select specs)

The prescription eye glass industry has been infused by the online retail phenomena as most other industries, the adage being that online sites that sell prescription glasses can offer them at a great discount. The lower overhead costs make it easier for online retailer to do this and the added competition is putting a squeeze on the traditional optician, this however is great news to the informed consumer. I always say competition brings out the best in all of us.

To fight back however, the local optometrists have stopped giving unsuspecting customers their pupillary measurements which are crucial in getting the glasses fit correctly. Many Opticians seem reluctant to give up this piece of information since they know that a customer who asks for it is more than likely to buy their eyeglasses elsewhere.

Right or wrong, this type of scotched earth policies will only lead to alienating many more customers. When I shop, I like many look for intangibles not just price breaks. I have no problem paying a little extra for something as long as the shopping experience was excellent for me, I want the freedom to do some comparison shopping for the best deal around too and holding me hostage by not providing me with all the tools and information I need just to try and rope me is really not the best way to handle this situation mister optician.

Their argument that under Current  General Optical Council regulations,  they are obliged to provide prescription details including Sphere, Cylinder, Axis and Add values, the PD measurement on the prescription form is somewhat ludicrous to me and does not hold any water.

It is a well known fact that this test is necessary and only takes a few seconds, so do it already or your customers will find a better alternative and head for the hills in droves.