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Hyde Park optometrist recommends eye exams for early diabetes detection

Posted by Jeremy C. Fox  November 26, 2012 01:07 PM

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Zoey Tolchin.jpg
(Jeremy C. Fox for Boston.com)
Dr. Zoey Tolchin.

November is American Diabetes Month, and one Hyde Park doctor wants people to know that an eye exam can be a quick, easy, and painless way to catch the disease early.

Dr. Zoey Tolchin, an optometrist at Clear View Eye Associates in Logan Square, said changes in vision can be the first sign of diabetes, and that dilating the eyes and examining the tiny blood vessels lining the retina can find signs of diabetes before it becomes evident elsewhere in the body.

“The blood vessels get sick from the sugar, and they will start to bleed,” Tolchin said in a recent interview in her office, as she pointed to photos of healthy blood vessels that looked like smooth, slender strings, and unhealthy vessels, which were uneven in thickness and appeared bunched up in spots.

“So instead of the vessel looking nice and smooth and pretty, it starts to look like this … it’s like little sausages,” she said.

It was announced Monday that Hyde Park’s best-known resident, Mayor Thomas M. Menino, has recently been diagnosed with type 2 diabetes, though not through an eye examination.

Tolchin is affiliated with VSP Vision Care, a non-profit vision benefits and services company, and spoke to a reporter as part of VSP’s campaign to educate consumers about diabetes risks and detection methods.

“The eye is really cool to look at for diabetes,” Tolchin said, “because the eye is really the only place in the body where you can see how blood vessels work without having to cut anything or do anything. You can just peek in and see.”

Diabetes is one of many potential health issues that optometrists look for as part of a standard exam, Tolchin said, along with vision problems such as glaucoma, cataracts, or macular degeneration.

Tolchin said she often sees signs of diabetes during exams with patients who haven’t yet been diagnosed. She especially watches out for those in groups more likely to have diabetes, such as Hispanics, African Americans, the obese, and older people. But even young people who are not in a high-risk group and have no obvious signs of being sick can turn out to have diabetes.

She has had several patients in their 20s, she said, who came to her because of a change in vision and then turned out to have bleeding vessels in their retinas.

“They completely had no idea,” she said. “Who thinks of diabetes in their 20s?”

She asks patients if they have had sudden changes in vision, such as “floaters” that appear in their fields of vision, or if they have been drinking a lot of water or urinating a lot, if they’ve had an unexpected weight loss. Those are among the most common signs that a person has developed type 2 diabetes.

Almost 26 million people in the US suffer from diabetes, according to the American Diabetes Association, and the disease kills more than 200,000 Americans each year. Nearly 27 percent of those 65 and older have the disease, with African Americans at the highest risk for type 2 — or adult onset — diabetes.

A recent study from the federal Centers for Disease Control and Prevention projected that the number of young people with type 2 diabetes would increase by 49 percent over the next 40 years, while the number with type 1 diabetes would increase by 23 percent.

Figures released last year by the Boston Public Health Commission showed that Hyde Park residents are more likely to die from diabetes than most other Bostonians.

Diabetes caused 4.3 deaths per 10,000 residents in Hyde Park from 2006 – 2008, a rate higher than that of any other neighborhood except Roslindale, where it caused 4.9 deaths per 10,000, and Roxbury, where it caused 5.1 deaths per 10,000.

Obesity is one common factor in adult-onset diabetes, and the health commission’s research indicated that obesity is on the rise in Hyde Park. Its data showed that 28 percent of Hyde Park adults were obese in 2008, compared to just 15 percent in data combined from 2003 and 2005. The citywide obesity rate for 2008 was 23 percent, 5 percent lower than Hyde Park.

When Tolchin sees signs of diabetes in a patient, she recommends a visit to the primary care doctor for testing and treatment. But she also said diabetes doesn’t always show up in an eye exam and that she recommends patients get regular checkups that include blood testing.

“The eye exam is just another way of finding it,” she said. “Especially it’s helpful for people who don’t go to the doctor on a regular basis. Sometimes people come in and they tell me, ‘I haven’t been to the doctor, ever.’ And they’re like in their 50s.”

Email Jeremy C. Fox at jeremy.fox@globe.com.
Follow Jeremy C. Fox on Twitter: @jeremycfox.
Follow Hyde Park on Twitter: @YourHydePark.

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