Among life’s joys for one area mom are the hours spent helping her preschooler sort beads of rainbow-colored crystals.

“We love beads,” says Julie Poindexter, 33, of Carthage, who works alongside her daughter, Dallas, to create handmade jewelry. On other days, she and her husband, Keith, watch their older daughter, Keilie, 8, lob tennis balls during afternoon lessons.

Since Poindexter has had diabetes for 25 years, these simple pleasures—so dependent on good eyesight—might seem unlikely. Studies show that the longer a patient has diabetes, the greater the likelihood of vision loss and blindness. For those like Poindexter, who developed diabetes before age 30, almost half have advanced eye disease.

Poindexter’s secret? Some luck, she says, but she is also extremely careful to do the things she is supposed to do, and avoid the things she’s not.

“I’ve made up my mind to take care of myself,” she says. “I want to be able to see—literally to see—my children and my grandchildren grow up.”

Blind in one eye since birth, she is highly motivated to maintain her sight.

No. 1 tip to ensure good vision: yearly exams
For anyone with diabetes, the No. 1 “secret” to maintaining the best vision possible is to have yearly comprehensive dilated eye examinations. This is key whether vision is poor or perfect, because warning signs are often non-existent.

“If you have poor circulation, the vessels and tissues at the far end of the complex path of the circulatory system will suffer first,” says Michael Bartiss, M.D., a board certified ophthalmologist on the medical staff of FirstHealth Moore Regional Hospital.

These include the tiny blood vessels that supply oxygen to the retina where, if circulation is poor, the body generates replacement blood vessels. These new vessels are often fragile, however, and they sometimes leak.

“Eye problems are like plumbing problems in your home,” says Kurt Jute, D.O., a board certified ophthalmologist on the medical staff of FirstHealth Richmond Memorial Hospital. “If you see a small leak, it’s very easy to fix. By the time it becomes a big leak, it’s done a lot of damage, some of which might not be possible to repair.”

Specialists want to spot the earliest of these leaks, at a time when sight-saving treatment can be most effective.

“Untreated eye disease is progressive,” says Dr. Bartiss. “When patients receive comprehensive exams every year, earlier changes can be spotted.”

Two common eye diseases that doctors want to identify early are diabetic macular edema, which causes blurry vision in the center of the eye, and peripheral diabetic retinopathy, which is the leading cause of blindness in adults in the United States.

For retinopathy, laser surgery and good follow-up care can reduce the risk of blindness by an impressive 90 to 95 percent, according to the American Diabetes Association (ADA). For diabetic macular edema, laser treatment reduces the risk of vision loss by 50 percent.

“But with macular edema, laser surgery does not necessarily restore vision,” says Dr. Jute. “That’s why treating it early is so important.”

Also important are preventing, delaying and stemming the progression of eye disease, things over which people with diabetes have a great deal of control, according to the ADA.

The tighter the control, the better your eyesight
The Diabetes Control and Complications Trial, a major study of 1,200 patients, revealed that those who had the tightest control of their blood sugar levels were best able to delay the onset and slow the progression of retinopathy. According to the New England Journal of Medicine, people with type 1 diabetes, and possibly those with type 2, who keep blood sugar levels within appropriate ranges can reduce eye damage by 76 percent.

To accomplish this control, people with diabetes should employ a team approach, with the patient and medical specialists working together.

For Julie Poindexter, having an ophthalmologist on her team saved her left eye.

“During a dilated exam in 1995, my ophthalmologist detected diabetic retinopathy, which he treated with laser surgery,” she says.

Since she had been blind in that eye since birth, the real danger was losing the entire eyeball, had the disease progressed unchecked.

Diabetic retinopathy often affects both eyes, so Poindexter feels blessed. “My right eye is fine,” she says. Regular and frequent exams help her keep it that way.

According to Poindexter, it wasn’t easy at first to incorporate the good habits that keep her at her healthiest today, but her own determination, her husband and her daughters help keep her on track.

“I need to take care of myself,” she says, “because if I don’t, I can’t take care of them.”