Elissa Cassidy is 33. Living in Ratoath, Co Meath with her IT manager husband, David, and their six-year-old daughter Alexandra, the young mother has had diabetes since childhood and has been a smoker for over a decade. These two factors combined have contributed to her losing the sight in one eye and suffering impaired vision in the other.

“I was diagnosed with diabetes in 1991 when I was 11 years old,” Elissa says. “I had the classic symptoms of thirst, frequent urination and feeling generally unwell. I have smoked for about 14 years but would consider myself a social smoker – I have tried to give up a few times but have always been unsuccessful.

"I now have diabetic retinopathy and although I'm not sure if smoking had a direct impact on my detached retina, I know the mismanagement of my diabetes did."

In denial
Although people have been known to reduce their insulin intake because of concerns over weight gain, Elissa reveals being in denial about her condition has undoubtedly led to the vision problems she has today.

“Personally I never had an issue with my weight so that wasn’t the reason I didn’t always take the correct dose,” she admits. “So I would like to highlight that there are other reasons a person with diabetes may choose not to take or alter their doses of insulin. I struggled in late teens and early adulthood with accepting that I had diabetes. And I felt resentful, angry and different to my peers.

"I viewed this illness in a very negative way. I had conflicting feelings because I knew if I was non-
compliant there could be terrible consequences but I also felt that I was young and nothing would happen to me and even if it did, it would be years from now.

“How wrong I was – the ‘years from now’ was actually 10 years later at the age of 27 when I began to have sight difficulties. I had just given birth to a beautiful baby girl and new life-changing events were unfolding.

"Sometimes I feel partly responsible for my
sight loss and I often ask myself why I didn't listen
to healthcare professionals and take better care of myself when I was younger. Diabetes is a serious illness but it is also an illness that you can live a normal healthy life with, so I cannot stress enough, particularly to younger people, the importance of managing the condition properly."

Brighter future
Retinal specialist David Keegan has been looking after Elissa's sight problems. He says with proper eye care and management of her diabetes, she should be able to enjoy a brighter future.

“Elissa’s prognosis is now reasonable in her right eye but is gone in her left eye,” he explains. “She is vision impaired and, for example, cannot currently drive. There has been some fluctuation in her vision, often improving to the driving level but not sustained. Our goal is to enable her to live an independent life and look after her family and I believe she will be able to do that.

“It is difficult to say how many people have eye problems as a direct result of smoking or lifestyle choices, but smoking usually contributes as an additional, modifiable risk factor in that it increases the risk of eye disease.

“ Smoking can increase the risk of sight loss due to age-related macular degeneration and cataract by two or three-fold, thyroid eye disease by four-fold and it will make diabetic retinopathy worse.”

Keegan advises anyone with a family history of glaucoma or age-related macular degeneration to attend their optician or eye doctor for an assessment. If they have diabetes, they will be invited to the National Diabetic Screening Programme to try to detect diabetes-related eye disease prior to sight loss developing.

For more information or to pick up a copy of the free eye health booklet , Your Sight, Our Vision, visit eyedoctors.ie or call 01 402 2777.