India is emerging as “Diabetic Capital” of world: 72 million cases recorded in 2017, figure expected to nearly double by 2025. Diabetes is a disease that inhibits with the body’s ability to use and store sugar, which may lead to several health problems. Excess sugar present in the blood may cause damage in the entire body including eyes and may cause Diabetic retinopathy, early cataract, Glaucoma or hemorrhage. The most common eye complication in diabetes is Diabetic Retinopathy.
What is Diabetic Retinopathy?
Diabetic Retinopathy is an eye complication that occurs in a person due to diabetes and causes continuous damage to the light-sensitive tissue at the back of the eye (the retina).
Diabetic retinopathy develops as a result of prolonged periods high blood levels. Over time, this can weaken and damage the network of tiny blood vessels (capillaries) on the surface of retina. These tiny blood vessels drip blood as well as other fluids that results in swelling of retinal tissue and clouding of vision. It can lead to blindness if it is left untreated.
Diabetes and your eyes
Diabetic Retinopathy is the leading cause of Avoidable blindness in Indian working-age adults ages 20 -74; however, early detection
and timely treatment can reduce the risk of avoidable blindness by 95%.
It is important to schedule annual diabetic eye exams to ensure your eyes are healthy.
25% of population is either diabetic or pre-diabetic. 1/3rd of diabetic individuals will develop Diabetic Retinopathy (DR) and 1/3rd out of them will become blind.
2 out of 10 become blind due to Diabetes.
What is the cause of Diabetic Retinopathy?
Diabetic Retinopathy occurs mainly due to the changes in the blood vessels of the retina. Diabetes produces weakening of the blood vessels in the body. The tiny retinal blood vessels are particularly susceptible. This deterioration of retinal blood vessels accompanied by structural changes in the retina will lead to loss of vision. When the loss of vision is caused due to diabetes, a Diabetic Retinopathy occurs.
What are the symptoms of Diabetic Retinopathy?
Diabetic Retinopathy produces ocular symptoms only in the last stage of the disease. Only an ophthalmologist can detect in early signs of Diabetic Retinopathy. So, all Diabetic patients should undergo yearly eye (Retinal) examination. Symptoms like floaters, difficulty in reading and sudden loss of vision are seen in advance stages of Diabetic Retinopathy. Early detection and timely treatment significantly reduce the risk of vision loss.
Diabetic retinopathy is classified into two types:
1. NON-PROLIFERATIVE DIABETIC RETINOPATHY (NPDR)
is the early stage of the disease in which symptoms will be mild or nonexistent. In NPDR, the blood vessels in the retina are weakened. Tiny bulges in the blood vessels, called microaneurysms, may leak fluid into the retina. This leakage may lead to swelling of the macula.
Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo.
Slit lamp, Bio-microscopy, Indirect Ophthalmoscopy and Fundus Fluorescein Angiogram (FFA) are used to diagnose Diabetic Retinopathy.
Prevention is the best treatment for diabetic retinopathy. Optimal blood sugar, blood pressure, cholesterol and weight control can reduce the long-term risk of vision loss from diabetic retinopathy. Cooperation with your primary care physician is very important to help keep your diabetes and other cardiovascular risk factors under control.
Once the diagnosis of diabetic retinopathy has been made, you may require more frequent eye exams. In addition, checking your blood sugar at home, recording your blood sugars in a notebook, and showing these numbers to your primary care physician are critical to success in controlling your disease.
Medical treatment for diabetic retinopathy may involve the use of injections of medicine into your eye (intravitreal injections) to treat the buildup of fluid (diabetic macular edema). Recent science has shown that DME and PDR are controlled by a signal sent from the damaged retina called vascular endothelial growth factor (VEGF). Several VEGF blocking drugs (including Lucentis, Avastin and Eylea) and other medications (steroids and steroid implants) when injected into the eye can cause DME and PDR to regress. Most of these agents provide only temporary relief and need to be given repeatedly over a prolonged period of time.
2. PROLIFERATIVE DIABETIC RETINOPATHY (PDR)
is the more advanced form of the disease. At this stage, circulation problems deprive the retina of oxygen. As a result new, fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessels may leak blood into the vitreous, clouding vision.
Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur.
Laser treatment may be recommended for people with diabetic macular edema (DME). The goal of this treatment is to prevent further vision loss. The laser seals leaking blood vessels, reduces swelling and prevents new abnormal blood vessels from growing. For macular edema, the laser is focused on parts of the retina outside of the macula. Multiple laser treatments may be necessary. Laser treatment is not a curative procedure and does not always prevent further loss of vision.
Vitrectomy surgery in the operating room may be recommended if bleeding from diabetic retinopathy causes a vitreous hemorrhage and associated vision loss. Additionally, surgery may be needed to treat tractional retinal detachment in the setting of extensive blood vessel and scar tissue growth.
Vitrectomy surgery requires a team approach. Before surgery, you will likely need to have a physical examination with your general doctor to identify and possibly treat any medical conditions. Your surgeon and anesthesiology team will decide whether local or general anesthesia is appropriate for you. Most vitrectomy surgeries are performed as outpatient procedures with local anesthesia, and the patient may go home the same day. The length of the operation varies from 20 minutes to several hours depending on your condition. Other procedures may be combined with your vitrectomy, including peeling membranes or laser application, depending on your specific needs. Your surgeon will perform your vitrectomy using a microscope and tiny instruments that are placed into your eye through small incisions in the sclera, the white part of your eye.
Prevention
- Keeping blood glucose levels, cholesterol and blood pressure well controlled in the long-term helps to lower the risk of diabetic retinopathy.
- See your physician regularly and follow instructions about diet, exercise and medication.
- Take dilated eye examination once a year
- Quit Smoking
- Reach and Maintain a healthy weight
ARE YOU AT RISK FOR DIABETIC RETINOPATHY?
GET YOURSELF CHECKED FOR DIABETES. REGISTER IN OUR DIABETES CLINIC!!
All diabetic individuals need a complete comprehensive dilated eye examination every year. Call Tej eye center at +91 99240 88500 to get blood sugar and retina checked!
Diabetic Retinopathy-free India initiative
Diabetic retinopathy is asymptomatic to begin with. Most of the people are not aware of the eye component of diabetes and they do not go for routine eye checkup as they do it for sugar. Most people have the misconception that if the sugar is controlled, they would not have any eye complication due to diabetes.
In that context, to create awareness and to detect damages inside the eye (retina) of diabetic patient early, Tej eye center has signed a MoU with Health
& Family Welfare Department of Govt. of Gujarat during vibrant summit for Diabetic Retinopathy screening. It has been successfully running for last 01 year
in CHCs and PHCs of govt. setupusing high-end Fundus camera.