Diabetic a silent killer of vision
How does diabetes affect your eyes?
Diabetes can affect the retina in various ways. The most common vision-threatening impediment is Diabetic Retinopathy, which damages the retina of your eye. Diabetic Retinopathy is a microangiopathy that affects retinal blood vessels. It not only destroys the light-sensitive layer of the eye but also the main cause of microvascular occlusion and leakage. Due to this leakage in blood vessels, fluid accumulation and hemorrhages chance is certain. This is the first stage of Diabetic Retinopathy and also referred to as Non-Proliferative Diabetic Retinopathy (NPDR).
What happens in the late stages of Diabetic Retinopathy?
Due to the reduced blood supply to the retina in diabetic patients, eyes form their new blood vessels, called Proliferative Diabetic Retinopathy (PDR). These blood vessels are so frangible, that your eyes can start bleeding anytime, which leads to vision loss. This condition is also known as Vitreous hemorrhage. In some cases, due to severe forms of traction, retinal detachment occurs.
Diagnosis and tests for Diabetic Retinopathy:
India’s best diabetologists and ophthalmologists could bring the implementation of the screening program for retinopathy. The prominent complication in diabetes retinopathy is that patients won’t feel any ocular symptoms until the central part of the retina through which one sees is affected, or bleeding occurs due to new blood vessels.
Diabetic Maculopathy and its features:
The process and procedure of diabetic patients:
Every diabetic patient is advised to take a comprehensive eye check at the hospital every year. It involves:
Fundus Fluorescein Angiography (FFA) and Optical Coherence Tomography (OCT)
FFA is a procedure that involves the injection of a dye in the vein of your hand, and a rapid series of photographs of the patient’s retina are taken. These photographs help the ophthalmologists to know the status of the blood vessels in retina and blockages if any.
Optical Coherence Tomography (OCT) is a non-invasive retinal photography technique that uses infrared light that shows the biological tissues, layers in the retina, especially the macula. While OCT does qualitative and quantitative measurements of the retinal morphology, FFA tracks disease progression, and detect the reaction of the treatment of diabetic retinopathy.
Treatment for diabetic retinopathy
Before any treatment starts, good blood sugar level control is the most important step for retinopathy. Laser photocoagulation and intravitreal injections are the two most popular treatment advised for diabetic patients with sight-threatening retinopathy. The laser photocoagulation treatment is usually done in 1-3 sittings.
Diabetic retinopathy is a complication for both insulin-dependent and non-insulin-dependent diabetes mellitus. It is a condition in which high blood sugar level can lead to swelling in retinal blood vessels and even bleeding.
Most people, who have been suffering from diabetes for more than 10 years, don’t develop diabetic retinopathy. However, uncontrolled blood sugar levels increase the risk of this disease. While juvenile-onset (type 1) diabetes should be evaluated five years after diagnosis, adult-onset (type 2) diabetes should be evaluated at the time of diagnosis, and every year. In insulin-dependent diabetes mellitus, the prevalence of diabetic retinopathy is 97.5%, and that in non-insulin-dependent diabetes mellitus is 80%.
The dysfunction of blood vessels in the eyes due to high blood sugar levels can cause hemorrhage in the vitreous fluid, glaucoma, retinal detachment, and even complete blindness.
To prevent diabetic retinopathy, the only way is to keep your blood sugar levels at an even level. If a diabetes patient is also having high blood pressure, keeping that in check is helpful as well. However, whose diabetes is in control, can also catch diabetic retinopathy. So, examining your eyes once in a year can let you know if there is any retinal damage. So, treatment can be started as soon as possible.
In the early stages of diabetic retinopathy, you may not feel any kind of visible symptoms or you might have blurred vision. But in the later stages, you may develop a cloudy vision, blind spots, or floaters. But a clean and good vision doesn’t always mean everything is fine. This can be a setup for a disaster!
Yes, there are treatments available. But early treatment can slow down the progression of diabetic retinopathy. However, it cannot reverse any vision loss.
According to WHO, the present population of diabetics in India will be triple in number by the year 2025. So, India is going to face a high incidence of diabetic retinopathy in the next five years. Diabetic retinopathy can lead to vision-threatening lesions like macular edema, creation of new blood vessels that can bleed easily inside the eye.
According to extensive clinical studies and research on diabetic retinopathy in the United States, it is proved that laser surgery is more helpful in patients with diabetic retinopathy than no other treatment.
There are no other treatments available than laser treatment to patients with diabetic retinopathy. Luckily, this treatment is affordable to the common man and is pocket-friendly like any other common eye surgery.