Diabetes mellitus is a condition which impairs the body's ability to use and store sugar. The past two decades have seen an explosive increase in the incidence of diabetes in India, which has the largest number of diabetics in the world today.
This
increased incidence of diabetes and its complications has been attributed to change
in life style caused by increased urbanization, high calorie diet, decreased physical
activity and stress. Another cause for concern is that diabetes is striking at
an early age among the urban population.
Diabetics are also 25 times more likely
to develop blindness, twice as likely to have a stroke, 2-4 times more likely
to have myocardial infarction and much more likely to develop kidney disease or
undergo amputation.
Diabetics are also at high risk for eye complications,
the most common one being diabetic retinopathy
What
is diabetic retinopathy?
It is an advanced stage of the disease process
in which the blood vessels in the retina are damaged and leak fluid or blood.
It has been seen that 25 per cent of all diabetics develop this complication
after
10 years of diabetes and 50 per cent develop it after 20 years of diabetes. People
with type I diabetes [diabetes since childhood] are more likely to develop diabetic
retinopathy at a younger age.
Diabetics also have a higher incidence of cataract
and glaucoma and those with poorly controlled blood sugar and blood pressure are
at a higher risk of losing vision.
What are the symptoms
of diabetic retinopathy?
Early diabetic retinopathy usually has no symptoms.
Gradual blurring of vision may occur if fluid leaks in the central part of the
retina [the macula]. In late diabetic retinopathy [proliferative stage], new
abnormal
blood vessels begin growing on the surface of the retina or the optic nerve. These
vessels have weak walls and leak blood out into the retina and vitreous [jelly
that fills most of the eye]. Presence
of blood in the path of light entering
the eye blocks vision.
How is diabetic retinopathy
diagnosed?
A complete eye examination is required for the detection of
diabetic retinopathy. The retina of the eye is examined using an instrument called
the indirect ophthalmoscope after dilating the pupils. If diabetic retinopathy
is found, a special test called fluorescein angiography (FFA) may be performed
where a dye is injected in the vein and photographs of the retina are taken.
How
is diabetic retinopathy treated?
In early cases only regular follow-up
may be necessary. More advanced cases require treatment to control the damage
of diabetic retinopathy and improve sight. Laser photocoagulation involves the
focusing of a powerful beam of laser light on the damaged retina to seal leaking
retinal blood vessels and stop abnormal blood vessel [neovascularization] growth.
Vitrectomy - In the event of the patient presenting with very advanced diabetic
retinopathy, a microsurgical procedure known as vitrectomy is recommended. Blood-filled
vitreous gel of the eye is replaced with a clear solution to aid in restoring
vision. Sometimes the retina may also be detached. Vitrectomy surgery is then
performed to reattach the retina.
How to prevent
visual loss in diabetes
Early detection of diabetic retinopathy and timely
laser treatment is the best protection against loss of vision. Diabetics must
have their eyes examined regularly. The preventive measures are designed towards
providing regular preventive care as well as follow-up for patients with established
diabetic retinopathy. Additionally, all diabetics must maintain control of blood
sugar and blood pressure and follow a regular exercise regime and healthy diet.
The
Diabetic Retinopathy Treatment Plan
The objective of treatment is for the
special purpose of preserving sight in sight-threatening conditions such as diabetic
retinopathy
Diabetes needs regular follow-up since
the condition can lead to a dramatic loss of vision if poorly treated or neglected
Various factors govern the rate of progression of your condition. It is therefore
necessary to review your eye condition periodically even after the present condition
has been treated.
The patients receive specialized care provided by
our diabetic retina specialists
At each visit, we check your vision,
intraocular pressure, do a slit-lamp biomicroscopy and perform a detailed retinal
examination with dilated pupils using an Indirect Ophthalmoscope. We record images
on the advanced Visupac system and maintain records of your eye condition for
comparison on following visits. We also monitor factors that control the progression
of your eye condition such as diet, blood sugar levels, exercise, blood pressure
etc.
Perform special procedures like Fluorescein Angiography, Laser
Photocoagulation and Ultrasonography if required.
All
diabetics must have the eyes examined regularly with dilated pupils. Juvenile
diabetics must have their eyes examined atleast once a year after the age of 12
years because diabetic retinopathy is rarely known to occur before puberty. Those
with diabetes at an older age must have the eye examination done once at the time
of diagnosis and then at least every 6 months to one year thereafter. If Diabetic
Retinopathy has been diagnosed, they should have the eyes examined as often as
recommended by their eye doctor.