‘Diabetes by far No. 1 cause of blindness in CNMI’

According to Dr. Don Hardt of Hardt Eye Clinic, diabetes is by far the No. 1 cause of blindness in the CNMI.

“Many others do not go blind but suffer from severe vision loss that cannot be corrected with glasses. Diabetes can damage virtually every structure in the eye,” Hardt said.

Hardt pointed out that the list of ocular complications that comes with diabetes include diabetic retinopathy (the No. cause of blindness), cataracts, dry eyes, corneal keratopathy, cranial nerve palsies, diabet pappilopathy, and ischemic optic neuropathy.

“Symptoms vary from mild to very severe. In many cases there are no symptoms until irreversible damage has occurred,” Hardt said.

According to Hardt, 700 people were seen last year that were already diagnosed with diabetes.

About 74 percent of them had diabetic retinopathy.

Diabetic retinopathy is a complication of diabetes that affects the eyes. It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye that can eventually result in blindness according to the National Eye Institute.

Diabetes is the non-communicable disease that causes the most problems. However, hypertension also leads to serious problems for many, these problems can include blindness.

“When diabetes is combined with hypertension, the effects on the eye are worse from both diabetes and hypertension when they are combined. In the U.S 71 percent of those with diabetes also have hypertension,” Hardt said.

Hardt knows this because he is the first Certified Diabetes Educator in the history of the CNMI back in 2010. There are now four CDEs. Hardt and his brother are two out of the 10 eye doctors in the entire U.S who have become CDEs. There are also no other CDEs or CDE programs in the other U.S Pacific Islands.

What is usually recommended by your clinic after check up? Hardt said that the advice they give depends on their condition. If they have severe retinopathy that is threatening severe vision loss, some will need ocular surgery. The patients are usually referred to their certified and fellowship trained ophthalmologist, Dr. Loren Seery, who visits their office from Guam.

“He performs laser surgeries in our office. Other patients need injections [called intravitreal] of medication into the eye. Most of the ocular complications of diabetes are treated by my brother and I,” Hardt said.

Hardt said that the most important thing for most people with diabetes is improved blood sugar control. “Medications are important, and can help a lot, but lifestyle changes are usually required for the best control.”

Hardt Eye Clinic works closely with the primary care physicians to achieve that goal. After every visit with one of their doctors or CDE, they would usually send a report to the primary care physician, according to Hardt.

Hardt Eye Clinic also provides CDE programs, one being Diabetes Self Management Education done by their nurses both for newly diagnosed patients, or patients who have never had the diabetes education before.

“Fighting diabetes and preventing its complications has become the passion of my professional life. While we provide many other important services in our clinic we are focused strongly on diabetes. All of the services we provide are fully covered by every major insurance companies in the CNMI. We also take care of many who have no insurance. So far we have treated every person with diabetes, regardless of their ability to pay, seeing many for free. We will continue to do this as long as we’re able to financially,” he said.

“It is absolutely critical that every patient with diabetes have their eyes checked at least one time per year. Those with retinopathy or other complications need to be seen more often,” he added.

Hardt is also the newly elected chair for the Non-Communicable Disease Alliance, a group of NCD advocates helping to promote a better life for people in the CNMI.