Focusing on a Problem : Diabetic Eye Clinic Offers Needy a Sight-Saving Program

From where Rosalia Lopez was sitting, the view wasn’t looking too good.

Actually, it wasn’t looking like much at all. For some time, a chronic case of double vision had turned parts of her world into a blur of shadow and light.

But while she considered her poor eyesight a nuisance, the 28-year-old Oxnard woman rarely thought about it otherwise. She figured that the fog clouding her vision could easily be lifted by eyeglasses, if only she owned a pair.

That was before she was diagnosed last year with diabetes. That was before she learned that the disease is the leading cause of preventable blindness in the United States.

And that was before she was told that diabetes is especially hard on people such as her: Latinos have higher rates of complications related to the disease, including severe eye disease that can lead to blindness.

So that’s how Lopez wound up sitting in the middle of a new diabetic eye clinic at St. John’s Regional Medical Center in Oxnard, working her way down an eye chart until the letters turned into squiggly black lines that she could not decipher.

Minutes earlier, her blood pressure had checked out fine. But her blood-sugar level was high, prompting retired optometrist Albert Forbes to hustle over with his eye doctor tools and a furrowed brow.

“I worry that this could be some kind of galloping situation,” said Forbes, fearing diabetes-related eye damage. “The only way to find out is go in and take a look.”

It was Forbes’ idea to start the free eye screenings, which debuted this month at St. John’s hospital. The idea is to screen diabetics, especially those who can’t afford regular eye exams, for eye problems related to the disease, and to funnel those with problems to ophthalmologists for care.

Of the estimated 14 million diabetics nationwide, Forbes said, half have never had such exams.

To those who know Forbes best, the creation of the program comes as no surprise.

The 76-year-old eye doctor sold his East Los Angeles optometry practice 11 years ago and retired to the beach in Oxnard. But he didn’t stay retired.

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About four years ago he started providing free vision care for children and senior citizens in Oxnard’s La Colonia barrio through programs at St. John’s.

He went on to establish eye-care clinics for the poor at the county hospital in Ventura and at a public health clinic in south Oxnard.

It was at those clinics that he saw waves of diabetics--mostly poor Latinos without health insurance--with eye problems potentially related to the disease, problems similar to those he was seeing when he opened his Los Angeles practice in 1946.

He set out to establish the screening program, and earlier this year persuaded St. John’s to donate space, staff members and volunteers to drive the effort.

“I didn’t originate this, for gosh sakes,” Forbes said. “What we’re trying to do is prevention. We’re trying to get them in the early stages.”

With word spreading at churches, health fairs and health clinics, the list of diabetics who want their eyes examined has grown long. Organizers hope to stage the screenings at least once every two months.

“The need is so big in the community, we didn’t have any trouble filling our schedule,” said Iluminada Camacho, a health education specialist at St. John’s who helped set up the program. “It’s so big it’s like an epidemic.”

Until last year, Rosalia Lopez knew nothing about this epidemic.

She had been tested for diabetes when she was pregnant with her first child two years ago, and the disease was nowhere to be found. But last year, pregnant with her second child, she was tested again and there it was.

“There are a lot of people with diabetes, especially Mexicans,” said Lopez, who has the type of diabetes that requires daily injections of insulin. “They say it’s because of our diet.”

She is only partly right. Nationwide, Latinos are twice as likely to have diabetes as Anglos, according to the American Diabetes Assn. Inadequate medical care, high-fat diets, language barriers and possibly genetic makeup contribute to the high rate among Latinos, health officials say.

Already under a doctor’s care to manage the disease, Lopez learned of the screening program at St. John’s and showed up Wednesday.

Volunteers measured her blood sugar and her blood pressure. She made her way down an eye chart as far as she could. Then Oxnard optometrist Thomas L. Wolf, who volunteers at the clinic, conducted a brief eye exam and put drops in her eyes to dilate her pupils.

Twenty minutes later, in the darkness of a hospital conference room, Wolf was looking deep into her eyes, training a powerful beam of light inside. With the pupils wide open, the light allowed Wolf to scan Lopez’s retina for damage.

“You’re OK,” he told her at last. “Everything is OK in the back of the eye.”

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For half a day, the routine repeated: blood sugar then blood pressure, eye chart and then eye drops. Most patients checked out fine, but were told that such screenings should become a regular part of their diabetes treatment.

They were then fitted with a flimsy pair of plastic sunglasses--to guard their dilated pupils against the sun--and sent on their way.

Some, such as Lopez, were given appointments to be fitted for a free pair of glasses. Others were referred to St. John’s support groups and educational classes for diabetics.

And a few were not screened after they were deemed to be at risk for strokes or heart attacks because of sky-high blood pressure or blood-sugar levels.

“First things first,” said Forbes, urging those patients to receive immediate medical attention. “They come in for eye exams and you give them a broader health perspective.”

Across Ventura County, the broader perspective on diabetes is rapidly unfolding, especially for Latinos.

While Latinos make up only about a quarter of the county’s population, they make up half of the county’s estimated 60,000 diabetics, according to the American Diabetes Assn.

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The Ventura County Medical Center runs a diabetes clinic that includes annual exams for eye disease, as well as screening for diabetes-related vision problems when patients enter the program.

Dr. Martha Gonzalez, who runs the county clinic, said she welcomes any effort to screen for diabetic eye disease as long as there is a solid system of referrals to ophthalmologists in place.

“We have patients show up here blind who never knew they had diabetes,” she said. “We are so far behind, any type of screening is necessary.”

That is Salvador Pujol’s attitude as well. The 49-year-old Oxnard man has lost family members to diabetes, and he was diagnosed with the disease two months ago.

He made his way in for a vision screening Wednesday after learning about the program from his diabetes counselor at St. John’s.

“This is fantastic,” said Pujol, who controls the disease with a combination of exercise and a good diet. “It’s a great opportunity for all of us who are diabetics.”