Diabetic Eye Disease : Reducing the Risks
Diabetes is one of the fastest growing diseases in India. In 1995 nearly 135 million people had diabetes throughout the world. However, the World Health Organization (WHO) has estimated that in India, the number of adults with diabetes would be the highest for any part of the world; a startling 195 percent increase, from 19 million in 1995 to 54 million in 2025.
What is diabetic eye disease ?
Diabetic eye disease refers to a group of eye problems that people with diabetes may develop as a complication. All can cause severe vision loss or even blindness. Diabetic eye disease includes Cataract, Glaucoma and Diabetic Retinopathy – damage to the blood vessels in the retina. In addition, diabetes can affect the optic nerve and cause anterior ischemic optic neuropathy (AION). II may weaken the nerves that supply the external muscles of the eye.
Who is at risk for diabetic retinopathy What is diabetic retinopathy ? How does it damane the Retina?
All people with diabetes are at risk. During pregnancy, diabetic retinopathy may worsen. The longer a person has diabetes, the greater the risk of developing Diabetic Retinopathy. Nearly half of all people with diabetes will develop some degree of Diabetic Relinopathy during their life-time.
Normally, the retinal blood vessels do not leak. But in patients with diabetes, the retinal blood vessels can develop tiny leaks, which cause fluid or blood to seep into the retina. Retina becomes wet and swollen and cannot work properly. This is known as diabetic retionopathy.
The central part of the retina is known as macula, and is the most important and sensitive area torus to see and read. In patients with diabetic retinopathy, if the .darilaged blood vessels leak fluid and lipids onto the macula, it results in a condition known a diabetic maculopathy, an important reason for blurring of vision in diabetics.
How is it treated ?
There are two ways to treat diabetic retinopathy. These are very effective in reducing vision loss from this disease.ln fact, even people with advanced retinopathy have a 90 percent chance of saving their vision provided they get treatment before the retina is severely damaged.
The two treatments are laser treatment and vitreous surgery. It important to remember that though both of these treatments are very successful, they do not cure diabetic retinopathy.
Laser treatment is done in the office as an outpatient procedure. Laser treatment is done to treat both diabetic macular edema and proliferative diabetic retinopathy. Timely laser can reduce vision loss from macular edema by half. But you might require laser more than once to control the leaking fluid. Laser light helps in sealing leaking vessels to stabilize the vision.
Similarly, Laser treatment is used to destroy new and abnormal blood vessels that form at the back of the eye. In such cases, rather than focus the laser light on a single spot, hundreds of small laser spots are placed on the retina. This is called scatter laser treatment. This treatment shrinks the abnormal blood vessels. Remember laser treatment for macular edema does not improve the vision; it only stabilizes it.
Instead of laser surgery, some patients may require an eye operation called vitrectomy to restore vision. This procedure is performed to remove blood from inside the eye and to treat retinal detachments, if any.
Remember, if proliferative diabetic retinopathy remains untreated, about half of those who have it become blind within five years, compared to just five percent of those who receive treatment.
How does one prevent these complaints
Regular check up is the only way to prevent these complications. Annual eye examination is a must for all diabetics from the time of diagnosis of the disease even if vision is perfectly normal. If any complications develop more frequent examinations are required. Eye examinations must be done by an eye specialist & not an optomerist. The examination should include vision checkup, record of spectacle power, slit lamp examination of the eye, record of eye pressure and retinal examination with pupillary dilatation. All findings should be carefully documented. Patients are advised to maintain all records properly so that smallest changes may be detected.
The state of the retinal vessels gives a clue to the treating diabetologist or physician about the state of the blood vessels in other parts of the body. So this report helps them assess your diabetic status better & provide better care for you !!