Diabetic Retinopathy Dr. V Mohan Chairman, Dr. Mohan’s Diabetes Specialities Centre
The various complications of
diabetes, visual impairment is perhaps the most feared by people with diabetes.
Diabetic individuals are much more prone to visual disability than non-diabetic
individuals. The impact of visual impairment among diabetic individuals has
profound implications for the person affected and society as a whole.
Visual disability significantly
affects the quality of life and increases the risk of injury. The most
distressing effects of diabetes in the eye with regard to visual impairment are
in the retina (inner layer of the eye) called as diabetic retinopathy.
Preventive approaches to diabetic retinopathy can be categorized into three
levels, the first is Primary Prevention of retinopathy.
This is an early approach where early detection
and appropriate treatment are the cornerstones for delaying the onset of the
diabetic retinopathy symptoms by good control of blood sugar, blood pressure
and lipids. It is mandatory that every type 2 diabetic individuals should have
a retinal examination at the time of diagnosis of diabetes and for type 1
diabetic subjects retinal examination should be done 5 years after diagnosis
and every year thereafter.
Diabetic retinopathy basically
divided into two types
- Non-Proliferative Diabetic Retinopathy
- Proliferative Diabetic Retinopathy.
Non-proliferative diabetic
retinopathy is the early stage of the disease and at this stage there are small
balloon like sacs (out pouching of capillaries) called as micro aneurysms. In
the next stage, these sacs leak fluid and blood into the retina. During this
stage, no sight loss is present. However, once diabetic retinopathy progresses,
prevention of the same would form the second approach or Secondary
Prevention. As part of secondary prevention one can prevent the progression of
this stage by advocating good control of diabetes in addition to documenting
the retinal changes by colour retinal photography. This is made possible by the
advent of the digital system of colour photography, which makes it easier for
the eye specialist to explain to the subjects about the retinal condition. As a
follow up, dilated retinal examination should be done more frequently at this
stage of the disease.
As individuals may not have any diabetic retinopathy
symptoms, life-long evaluation for retinopathy is a valuable and necessary
strategy. It has been estimated that in whom eye examination had not previously
been performed, 50% subsequently had visual disability due to diabetic
retinopathy.
The two sight threatening forms of
diabetic retinopathy classification are diabetic macular edema (DME) and
Proliferative diabetic retinopathy. In DME there is collection of fluid in the
critical central region of the retina, called as the “macula” (the “seeing”
portion of the eye). In the second condition – Proliferative DR there are “New
Vessels” on the retina. These new vessels are outgrowths from the normal
vessels and appear in the retina due to lack of oxygen called as hypoxia. The
problem with the new vessels is that their walls are very friable and they have
a tendency to bleed. If this stage is not treated it may lead to gross visual
disability.
Tertiary Prevention would be the
late approach where complications have reached a very critical stage and
interventional procedures like laser therapy and or surgical procedures are
required to prevent the progression of disease and stabilize vision. Laser
therapy is a simple out-patient painless procedure. If done in the proper way,
the diabetic changes in the retina can be completely reversed. After the procedure,
regular monitoring is necessary as diabetic retinopathy symptoms may recur
being a systemic disease. Timely treatment can prevent up to 90% of vision loss
from diabetic retinopathy.
Other diabetes related eye problems are glaucoma (damage to optic nerve fibres), senile cataract due to ageing
(clouding of the lens) and nerve palsies (affection of extra ocular muscles).
People with diabetes are twice likely to suffer from glaucoma than people
without diabetes and risk increases with age and duration of diabetes.
Thus, people with diabetes can
prevent/reduce the occurrence of diabetic eye complications. Improved
awareness, education, screening and treatment, will go far toward
preventing/reducing blindness due to diabetic eye disease.
Having Queries? Kindly contact us for
more details.
Call to discuss:
Phone: 07825888631, 044 43968888
DIABETES CENTRE IN GOPALAPURAM
No.6-B, Conran Smith Road, Near
Sathyam Cinemas, Gopalapuram, Chennai, Tamil Nadu 600086.
Social Media:
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