Diabetic Retinopathy
"The retinal layer in the eye can get damaged due to vascular changes caused by diabetes". Though all parts of eye can be affected by Diabetes, the retinal layer is important because it lacks alternate blood supply and the complications can lead to irreversible blindness. With increasing prevalence of Diabetes in the country, the diabetic retinopathy is fast becoming major eye health problem. Diabetes is a systemic disease that affects the blood vessels in every part of the body including eye. The blood vessels in the retina can become leaky leading to edema of the retina (accumulation of fluid in the layers of retina). The blood vessels may get occluded leading to ischemia of the retina and new blood vessels formation. These new blood vessels being fragile may lead to recurrent bleeding inside eye and tractional retinal detachment causing loss of vision.
How do I know that I have diabetic retinopathy?
Anyone with diabetes can develop retinopathy and the retinopathy may remain silent till it has progressed to a late stage. The duration, control of diabetes and genetic susceptibility of the individual are important in developing retinopathy. The importance lies in intervening in early stage to prevent the sight threatening complications. Hence those with diabetes mellitus are advised to undergo comprehensive eye examination including dilated retinal examination at least once a year or as recommended by your eye care provider.
What preventive measures I can take to prevent retinopathy?
Strict adherence to diabetic diet, exercise, and compliance with medications advised by your physician is very important. A strict control during early years of diagnosis will help in long run in the prevention of diabetic complications including retinopathy.
When should I get my eyes examined?
The first examination should be done as soon as you are diagnosed with diabetes. If you don’t have any retinopathy changes, a regular yearly will be sufficient or as advised by your eye doctor. If you are having any retinopathy changes, your eye doctor may advise frequent eye examinations to monitor and treat the retinopathy.
What to expect during eye examination?
A comprehensive eye examination including vision testing, refraction, IOP check and dilated retinal examination will be done. As it may take more time in dilating your pupils, the examination may take half an hour to one hour for the examination. The dilatation of pupils may cause increased light sensitivity and blurred vision, it is advisable not to take your vehicle when you go for eye check-up or you should be accompanied by a friend or family member. If the doctor finds any complications of retinopathy, he may advise further tests like OCT or flouroscein angiography which may be scheduled at alter date or done in the same visit.
What are the complications of diabetic retinopathy?
Diabetic macular edema (fluid accumulation in retinal layers due to leaky vessels), vitreous haemorrhage (bleeding from the fragile abnormal new vessels of retina) and tractional retinal retinal detachment in late stages.
How to prevent these complications?
Best way is to have good diabetic control and regular eye examination. Early intervention can save you from vision threatening complications and outcome can be much better. Gv eye world is equipped with state of the art OCT to detect and monitor diabetic macular edema and Multispot green laser to do retinal laser for the prevention of retinal complications.
What are the treatments involved in diabetic retinopathy complications?
The macular edema is generally treated with Anti VEGF injections or sustained release steroid implants placed in the eye. The frequency of injections, efficacy, suitability and the cost involved can be discussed with your doctor before initiating treatment.
The bleeding vessels may require laser photocoagulation to prevent recurrent bleeding and developing into tractional retinal detachment. Gv eye world has multisport green laser which reduces number of visits to hospital for laser treatment and also increases compliance and comfort during treatment in contrast to single spot laser. Ours is the only second hospital in Hubli to have such facility.
What are the other eye complications of diabetes?
The other eye complications of diabetes include frequent change in refraction, epithelial healing problems, early onset or rapid progression of cataract and higher occurrence of glaucoma.