What is Diabetes?

Diabetes is a chronic disease that occurs when the Pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Raised Blood sugar is a common effect of uncontrolled diabetes, and over a period of time, it leads to serious damage to many of the body systems, mainly Eye, Kidney and the brain.  When it affects the eye is called “Diabetic Retinopathy”.

What is Diabetic Retinopathy?

High blood sugar can damage the blood vessels in the “RETINA” the nerve layer at the back of the eye that senses the light and helps to send images to the brain. The damage to the retinal blood vessels is referred to as “Diabetic Retinopathy.  Eye involvement in Diabetes can result in blindness if not detected and treated early.

What are the types of Diabetic Retinopathy?

There are 2 types of Diabetic Retinopathy.

  • Non-Proliferative Diabetic Retinopathy (NPDR).
  • Proliferative Diabetic Retinopathy (PDR).

NPDR is an early stage in which tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to well or form deposits called “Exudates”.

In PDR abnormal new vessels being growing on the surface of the retina or the optic nerve. These vessels can rupture and bleed or can cause scar tissue.

What causes vision loss in Diabetics?

  • Macular Edema:  Swelling or thickening of the macular (central vision area).
  • Macular Ischemia:  When small blood vessels close.
  • Vitreous Hemorrhage:  Fragile abnormal blood vessels bleed into the vitreous.
  • Retina Detachment:  Abnormal blood vessels can undergo scarring causing detachment. 

How do I know I have Retinopathy? 

Normally one does not know your vision is affected until serous eye changes happen.

Only a complete eye examination by an ophthalmologist (eye specialist) can detect Diabetic Retinopathy. For this, a detailed fundus examination is done with a special equipment.

  • If diabetic retinopathy is detected the doctor may order for color photography of the retina or a specialized test called Fundus Fluorescein Angiography may be carried out find out if you need treatment.
  • Optical Coherence Tomography (OCT):  This is special scanning test in order to find out the amount of thickness at the macular.
  • Ultrasound scan (B-scan):  Many be necessary if there is severe bleeding (vitreous Hemorrhage) to decide on further treatment.

 

How can Diabetic Retinopathy be treated?

Strict control of one’s blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy.

  • Laser treatment is commonly done for Macular edema, wherein laser id focused on the damaged retina in the macular to decrease the fluid leakage.

PROLIFERATE DIABETIC RETINOPATHY (PDR) laser treatment knows as Pan Retinal Photocoagulation (PRP) treatment causes abnormal new vessels to shrink and prevent further bleeding.

  • VITRECTOMY:  In advanced PDR a specialized microsurgical procedure performed in the operation theatre is recommended wherein the blood-filled vitreous is removed and is replaced by a clear solution.
  • INTRA VITREAL INJECTION of Triamcinolone Acetonide, a weak steroid has shown to effectively reduce central macular thickness. A recent advance is an Intra-Vitreal injection of VEGF (Antie-vascular endothehal growth factor) which helps in reducing the blood vessels which re-bleeds.

Can vision loss be prevented?

You can significantly lower the risk of vision loss by maintaining strict control of your blood sugar and visiting the eye doctor regularly.

“EARLY DETECTION OF DIABETIC RETINOPATHY IS THE BEST PROTECTION AGAINST LOSS OF VISION”.

People with diabetes should schedule a thorough eye examination once a year, and thereafter every 6 months depending on the severity damage to the eye.