DIABETES & EYE CARE
We cannot prevent diabetes despite lifestyle changes & healthier living but we can certainly prevent vision loss due to diabetic retinopathy. High levels of blood sugar can lead to early Cataract development and or can lead to a condition known as Diabetic Retinopathy.
Nine out of ten people with diabetes will eventually develop a complication that affects the eyes known as diabetic retinopathy. This condition affects the retinal blood vessels and can lead to blindness, however, if diagnosed and treated early much of this vision loss can be prevented.
The retina is a highly sensitive thin tissue that lines the innermost part of the eye. It is this tissue that gives us our vision and is the part you are using now to read this note! There are tiny blood vessels on the Retina which bring oxygen and nourishment to it. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. At this point, most people do not notice any changes in their vision. Some people develop a condition called macular edema. It occurs when the blood vessels leak fluid and lipids onto the macula, (The central part of the retina that let us see in detail). The fluid makes the macula swell, thus blurring the vision. As the disease progresses, it enters its advanced, or proliferative stage. Fragile, new blood vessels grow along the retina and the clear, gel-like vitreous that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina.
It often has no early warning signs. At some point, though, the patient may have macular edema which causes blurring of vision. In extreme cases, a person will only be able to tell light from dark in that eye due to bleeding in the eye. It may take the blood anywhere from a few days to months to clear.
HOW IS DIABETIC RETINOPATHY DIAGNOSED?
By detailed dilated eye examination and by doing specialized tests like Fluorescein Angiography and OCT (Optical Coherence Tomography). Angiography and OCT decide the stage of diabetic retinopathy and the treatment of diabetic retinopathy.
HOW IS DIABETIC RETINOPATHY TREATED AT RUSHABH EYE HOSPITAL?
The treatment options for diabetic retinopathy include
- Intravitreal injections
- Surgery (Vitrectomy).
Anti VEGF’s (Lucentis, Avastin, Razumab) are emerging as the new and preferred modality of treatment for various stages of diabetic retinopathy. These are very effective in reducing vision loss from the disease.
This treatment aims to protect the central vision. It does not restore vision but can prevent further deterioration. In the early or non-proliferative stages, the laser is used to seal leaking areas from the blood vessels. The severity of diabetic retinopathy plays an important role in determining the number of laser sittings required.
A Vitrectomy is performed if there is a long-standing nonabsorbing vitreous hemorrhage (blood inside the eye) or a tractional retinal detachment.
HOW TO PREVENT LOSS OF VISION BECAUSE OF DIABETIC RETINOPATHY?
It has been proved that better control of blood sugar levels slows the onset and progression of retinopathy and lessens the need for laser treatment or surgery. Co-existing high blood pressure can speed up diabetic changes in the eye, so blood pressure also should be kept under control.
- Stop smoking: Smoking causes narrowing of the blood vessels, which can aggravate the diabetic changes in the eye.
- Have regular eye check-ups: All patients with diabetes should have an thorough eye examination through dilated pupils at least once a year. If patient has severed retinopathy, he/she may need to have a eye examination more often.