Luther Gore didn’t know what was causing the problems he was having with his vision in 2008.

“I kept trying to get glasses, but none of them would help,” he recalls. “I couldn’t see up-close at all, and it was getting to where I couldn’t see distances either. I needed to do something.”

He visited his local optometrist, Dr. John Marcin, who referred him to Walter E. Moscoso, MD, a board-certified, fellowship-trained ophthalmologist with Manatee Sarasota Eye Clinic.

“I went to Manatee Sarasota Eye Clinic,” Luther continues, “and they started running tests on me. That’s how I found out I was a diabetic.”

Long-term diabetes can cause damage to the blood vessels in the retina, a condition called diabetic retinopathy . When new blood vessels form on top of the retina and begin to leak or bleed, it can cause permanent damage to vision.

In Luther’s case, the problem was already underway.

“I told the doctor, Hey, doc, it looks to me like I have shadows in my eyes ,” he explains. “They were filling up with blood.”

Diabetes and cataracts

As Dr. Moscoso observes, eye diseases such as diabetic retinopathy and macular degeneration can be devastating to vision, but may often by managed through in-office laser procedures and periodic injections of medications such as Lucentis and Avastin.

“Luther progressed from the milder form, non-proliferative diabetic retinopathy, to the more aggressive proliferative variety,” explains the doctor. “He developed what we call a vitreous hemorrhage , where there is bleeding inside the middle of the retina. That prompted laser treatment in his right eye.”

Dr. Moscoso strongly recommends that those who are at risk for developing these types of conditions adhere to a healthy diet and follow all of their doctors’ recommendations.

“It’s always important for anyone to have a healthy diet and adhere to their primary care doctor’s regimen, particularly if they have diabetes or macular degeneration,” he says. “In diabetes, for example, controlling sugar levels has a great bearing on the level of diabetes, its progression, and how well the patient can do after cataract surgery.”

For Luther, this proved to be especially important.

“After his laser treatment, Luther had progression of cataract in the right eye as well,” recalls Dr. Moscoso. “There are special challenges with patients who have cataracts but also have a retinal disease like diabetic retinopathy or macular degeneration.

“In fact, most ophthalmologists are more conservative about recommending cataract surgery to those patients who have either diabetic retinopathy or macular degeneration. The retinal examination is extremely important before the surgery is done.

“We strive to make sure that there exists a good potential for having an improvement in vision after cataract surgery. If the retinal disease is not going to allow the vision to get better, then cataract surgery is not going to be as rewarding for the patient as it would be if their potential was good for a visual improvement.

“There are procedures that can be performed to enhance the postoperative vision in cataract surgery,” explains the doctor, “and also to give the patient a better idea of what visual improvements to expect.”

In Luther’s case, the potential for improvement in vision made it well worth the effort.

“He has very good vision in that right eye now,” adds Dr. Moscoso. “The last time I saw Luther, his vision was twenty-thirty, and that’s after cataract surgery. So despite the fact that he had the more advanced kind of diabetes, he has done very well.”

“Everything is clear”

Luther’s vision has indeed improved, as he reports, “I can drive at night and I can see the road signs. That was a problem before. And I couldn’t watch television either: it would just be a blur. Now, everything is clear.”

Luther expresses nothing but the greatest appreciation to Dr. Moscoso.

“I couldn’t see anything to begin with, and he made it where I can watch TV, and drive in the daytime and the nighttime,” he says.

“Dr. Moscoso and his staff are excellent. It felt like I was his only patient, and they all seem like they work as one unit. It was amazing. I would recommend him to anyone.”

FHCN – Michael J. Sahno