Written by Editorial Team |Updated : March 30, 2015 6:11 PM IST
Researchers claim that eye disease due to diabetes is the leading cause of vision loss among adults and diabetics should get regular eye check-ups. Diabetic retinopathy is an extremely common form of the disease and afflicts 28.5% American (where the study was conducted) who're diabetic and above 40.
Typically, diabetic retinopathy has no symptoms until it reaches an advanced stage. But the disease can be detected early through a comprehensive dilated eye exam. In this procedure, an eye professional will put drops in your eye to dilate (widen) the pupil, which allows a closer look at the retina.
In diabetes, your body cannot regulate the amount of sugar (specifically, glucose) in the blood. When uncontrolled, it can damage various organs. Diabetic retinopathy is damage to the retina (innermost layer of the eye) caused by prolonged and inadequate blood glucose control. The small blood vessels in the retina are damaged and weakened. The early symptom of eye problem related to diabetes is blurred vision and double vision. It can also cause a severe, permanent loss of vision. It also increases the risk of developing cataracts and glaucoma.
What is diabetic retinopathy?
Dr Prakash Nayak from Navi Mumbai Eye Clinic says, 'Common among diabetics, this ailment is caused by damage to blood vessels it the back of the eye. People may not notice this until the damage to the eyes is severe. There are four stages of diabetic retinopathy. During the first three stages of DR, treatment is usually not needed. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. For the fourth stage of DR, called proliferative retinopathy, there are treatments that reduce vision loss, but are not a cure for DR. Warning signs of diabetic retinopathy includes blurred vision, gradual vision loss, floaters, shadows or missing areas of vision, and difficulty seeing at night.'
Dr Haresh Asnani, a retina specialist from Advanced Eye Hospital and Institute, Navi Mumbai adds: 'This can be a very dangerous and fast progressing condition which requires surgical intervention in most of the cases. If not treated, it leads to end stage of diabetic retinopathy which is known as neo-vascular glaucoma. In this condition the intraocular (eye) pressure goes up due to blood vessels invading front part of the eye resulting in painful blind eye.'
How do you diagnose the condition?
During the early stages, there are no symptoms. A few blood clots may be visible on the retinal surface. As the retinopathy advances, a patient's vision starts decreasing. As retinopathy advances or diabetic maculopathy starts, a patient's vision goes down. When there is bleeding from the retina, patients experience floaters i.e. a shower of black spots in front of the eye. When the proliferative stage starts, the blood vessels pull the retina leading to retinal tears and sudden loss of vision. There is a certain amount of pressure in the eye which maintains the eyeball in its shape and also plays a role in blood circulation in the eye. The normal intraocular pressure is 17-20 mm Hg. If it goes above that it starts pressing on the optic nerve and retinal nerve fibre layer and cause gradual loss of vision. End stage diabetic retinopathy results in unbearable pain due to rise in intraocular pressure.
What are the treatment options?
Intravitreal steroid injections or anti-vascular endothelial growth factor injections are given to control diabetic maculopathy. In early stages of retinopathy when there is ischemia (lack of blood) of retina, laser treatment is used. In later stages surgical procedure called vitrectomy (removing the blood clot filled vitreous from the centre of the eye) is done and then the retina is treated with laser. Then a gas or silicon oil is injected as a substitute to the vitreous into centre of the eye. Sometimes injections are combined with surgery when there is excessive bleeding in retina.
The single most important thing you can do to prevent long-term complications of diabetes is controlling your blood sugar. Keep an ideal body weight and an active lifestyle. Have a balanced diet, increase your level of physical activity and maintain a healthy weight to stay healthier longer and reduce your risk of developing complications of diabetes.
Read more about causes, symptoms, diagnosis and treatment of diabetes.
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