Jeffrey Peil suffers from a progressive eye disease in which the retina is damaged. His vision started deteriorating in his 20s. He will eventually go blind.

Elijah Peil was born in September, but his father has yet to see him.

Jeffrey Peil can make out his son’s outline but not the details of his face.

"If I were to put a pair of sunglasses over your eyes, a patch over your right and a funnel over your left, that’s what I see through," says Peil of Fox Point. "I have this little tunnel that I live through."

Peil, 36, has retinitis pigmentosa, a progressive eye disease in which the retina is damaged.

"Basically, it’s a degenerative disease, it’s genetic," he says. "So I’ve had it all my life."

He was diagnosed at age 30 during an eye exam he scheduled to learn about LASIK surgery to improve his failing vision.

"I knew I had eye problems because I had actually given up driving at 27," he says. "I gave up night driving even before that.

"I actually started to not be able to read," Peil says. "I started walking into things."

After being diagnosed, he learned that retinitis pigmentosa, which first affects the peripheral vision, is rare, affecting one in about 2,000, but blindness is inevitable; vitamins can slow the disease’s progress, he says, and adult stem cell research may hold a key to a cure in the future.

"It will eventually rob me," he says. "I will continue to lose vision as long as I live."

He sought support at the Badger Association for the Blind and Visually Impaired in Milwaukee and came back with a cane, a seat on the group’s advisory board and a dose of denial.

"I carried my cane around in my pocket for about three months," Peil says.

Elevated blood sugar levels led to blurred vision for Mike Vescio. His doctor diagnosed diabetes, and a more healthy diet has lowered Vescio’s blood sugar and restored his vision.

"The one thing that’s almost a blessing for me is that it’s happening slowly," he says, which gives him time to adjust to a sightless world. "My challenges are known. But, yeah, you do some grieving. I really try to focus on the things I have, because I have a lot."

Big three

While retinitis pigmentosa is rare, the three leading causes of blindness — diabetic retinitis, cataracts and glaucoma — are not.

According to Eye Care Specialists’ Dr. Norman Cohen, about 2 million people in the country have glaucoma, a progressive disease of the optic nerve that first affects peripheral vision. About half who have it are asymptomatic, but those more at risk include blacks, the elderly and those with a family history of the disease.

"By the time they get symptoms, it’s well advanced," Cohen says. "Any damage that’s done is permanent."

Its causes, he says, are intraocular pressure, vascular pressure, the susceptibility of nerve cells to become damaged as well as genetics.

Detection, Cohen says, is paramount, as it can be well controlled by eye drops or laser treatments, which work by either reducing the production of fluid in the eye or enhancing its outflow.

"The key to treat is to lower the pressure," he says.

Dr. Jeffrey Kalenak agrees, adding that causes also include a past eye injury, congenital cataracts and diabetic retinopathy. And while age is often a factor, Kalenak says he has patients who are teens and young adults. "It’s not strictly older adults."

Kalenak, who in the 1990s with other researchers identified a gene linked to glaucoma, says there’s no known way to prevent it as it’s not tied to lifestyle issues.

"It’s not what you eat, smoke or drink," he says. "It’s what you’re born with."

Recent research, Kalenak says, suggests that visual field tests could help detect it early. But as only 2 percent of the population has glaucoma, testing everyone would be cost-prohibitive and, for the vast majority of patients, unnecessary.

"The best you can do is have your eyes checked and monitored," Kalenak says.

New cataracts treatment

Cataracts, meanwhile, primarily affect older adults, like Lavon Olander, 69, of Elm Grove. In fact, six out of 10 people over age 60 has a cataract.

"It’s a natural aging of the eye," says Robert Sucher, a surgeon with Eye Care Specialists and Olander’s eye doctor.

And like glaucoma and retinitis pigmentosa, cataracts, a clouding of the lens, usually run in families. Olander says her mother and a sister both had cataracts.

Olander had a relatively new procedure done — a multifocal lens implant — to remove the cataract in her right eye in August and her left in September.

Because it ran in her family, Olander says she was aware of the symptoms.

"You see a little twinkle around the light," she says.

"It’s a blur, it’s a loss of clarity," Sucher says. "They may get ghosting. They may get halos around lights at night."

Treatment, he says, is lens implants — either multifocal (allowing for distance and near vision), monofocal (allowing for distance vision only) or monovision (allowing for distance vision in one eye and near in the other).

With multifocal lens implants, patients have "the ability to have pre-40 vision."

"Left untreated, all the symptoms get progressively worse," he says.

Lifestyle factors

By far, though, diabetic retinopathy is the fasting-growing cause of blindness in the country, and it’s tied to lifestyle.

"It’s because of the eating habits and overweight problem that occur in the United States," says Dr. Brett Rhode of Eye Care Specialists.

Cohen says there are 20 million diabetics in the country, and each, if not careful, could develop diabetic retinopathy, a disorder in which small blood vessels in the retina weaken and break down or become blocked.

"There are millions of people undiagnosed in the United States right now," says Rhode. "Many times, we are the first ones to tell people they may be diabetic."

That was the case with Mike Vescio, a 36-year-old attorney who lives in Waterford. Vescio says that in spring, he unexplainably started getting very thirsty. "I began drinking up to 16 glasses of water a day," he says. "That was a major symptom."

But he didn’t pay it much heed until he "lost 20 pounds for no good reason.

"I was eating as sloppily as ever," he says.

And then, while playing tennis, his vision blurred.

"My eyes got so bad, I couldn’t see to read," Vescio says. "I knew that was another symptom. I can’t do my job if I can’t read."

He went to see his primary care physician, who diagnosed diabetes. Then he went to see Sucher, who tested him for diabetic retinopathy but found no pathology. However, Vescio’s blood sugar levels were so high, it affected his vision, which is not uncommon.

"In his case, the visual blurring was due to the blood sugar levels being higher than I was used to," Sucher says.

Once his blood sugar level was controlled, Vescio’s vision returned to normal. But that’s not always the outcome.

"High, prolonged blood sugar levels could have caused lasting changes in the eye, tears in the retina, which can cause blindness," Vescio says.

Today, Vescio takes metformin to control his blood sugar levels, checks his levels three times a day and has changed his diet to one with less fat, fewer carbs and no sugar except that found in fruit.

"Candy would be suicide," he says. "The biggest thing I miss is Mountain Dew. That’s just poison."

Once diabetic retinopathy is diagnosed, Sucher says laser treatments, steroid injections and, as a last resort, surgery can arrest it, although the damage done can’t be reversed.

For that reason, Sucher says the smartest way to maintain your vision, especially for those at risk of diabetes, is to see a primary doctor and an ophthalmologist every year.

"If people are able to control their blood sugar and see an eye doctor, their chance of having sight throughout their whole lives is great," he says.