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Diabetes is the leading cause of blindness among Americans of working age, but surgical advances in the past 20 years mean that most with the disease don't have to lose their vision, according to Salt Lake ophthalmologist Dr. Kirk E. Winward.

"In 1993, most diabetics (with eye disorders caused by the disease) can be stabilized and their vision maintained - that's with regular follow-up and appropriate treatment," said Winward, who is on the medical staff of LDS Hospital.He and Dr. John F. Ramsey, an ophthalmologist on the staff of Alta View Hospital, will make themselves available to answer questions from the public during the monthly Deseret News/Intermountain Health Care Hotline Saturday from 11 a.m. to 1 p.m.

Anyone with a question about eye disease or eye care can telephone the paper, free, for answers. The toll-free number, which can be dialed from anywhere in the lower 48 states, is 1-(800)-925-8177.

Winward specializes in diabetic retinopathy, which damages the vision of many people with diabetes. Approximately 14 million Americans suffer from diabetes, many of them not realizing they have the disease.

Sooner or later, most diabetics have retinopathy, causing at least mild damage to the eye's retina, he said. Many get severe complications, with 8,000 blinded every year. However, excellent treatment is available,

Winward said.

Anyone with diabetes "definitely should be followed regularly by an eye-care specialist. In most instances, the disease is mild and can simply be observed," he said. A diabetic should be treated by an eye doctor as soon as possible.

A person who has had diabetes for five to 15 years can develop severe eye problems. "Laser treatment will improve some people, but for the majority it ends up stabilizing a situation rather than improving it," he said.

Surgery with a laser beam usually takes place in the physician's office. Some procedures are painless and take 30 minutes, while others require local anesthesia. With worse situations, hospitalization is required.

Diabetes affects blood vessels throughout the body, and the eyes are often a target. Sometimes normal blood vessels leak plasma, causing the retina to swell.

In another disorder, abnormal blood vessels will grow into the center of the eye. "Those blood vessels are very fragile and they spontaneously rupture, frequently. When they do, they may bleed extensively and fill the eye with blood."

The blood causes a rapid loss of vision. Sometimes the eye can clear itself, but sometimes surgery is needed to remove the blood.

Both blood vessel disorders can be controlled by laser surgery. In the first, leaky vessels can be sealed by laser. In the second problem, lasers can zap the abnormal blood vessels, causing them to shrivel up.