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Diabetic Retinopathy

A Silent Marauder of Eyesight

Diabetic retinopathy (DR)  is a condition that occurs as a result of damage to the blood vessels of the retina due to long periods of uncontrolled high blood sugar levels. It’s the most common eye disease in diabetics which can lead to diminished eyesight or even blindness when left untreated. Longer the duration of diabetes, higher the chance to develop DR. Coexisting uncontrolled hypertension, high cholesterol levels, anaemia, kidney and/or cardiac disease, and pregnancy increases the likelihood of developing DR. It usually affects both eyes simultaneously and equally. In the early stages, the damaged retinal blood vessels become blocked and leaky and ooze out fluid or blood into the retina.  When it involves the centre of the retina, the macula, it causes macular edema which may lead to blurry vision. As the disease progresses, the eye attempts to fix the situation by growing new blood vessels which may leak, rupture or form scar tissue further impairing your vision. Patients typically do not experience any symptoms till advanced damage occurs. Floaters, blurred or distorted vision, dark or empty spot in your field of vision or sudden vision loss may be experienced by patients in advanced stages. In order to identify and treat DR, it is recommended that type 1 diabetics have their first dilated eye exam within first five years of diagnosis and during the time of diagnosis itself for type 2 diabetics. The number of eye exams subsequently will depend on the severity of the retinopathy. It is better to bring along the recent blood sugar reports and details of other ailments while coming for an eye check-up. A fluorescein angiography (FFA) and optical coherence tomography (OCT) scan may be done to assess the extent of damage and fluid collection in the retina. Early stages of DR rarely requires any treatment. A healthy lifestyle including a good diet and moderate physical activity along with  diabetic medications/ insulin prescribed by your physician is essential to keep your blood sugars at check. Macular edema can be treated by intravitreal injections or focal laser treatment. Scatter laser treatment is used to treat the abnormal blood vessels. In advanced retinopathy, a surgical procedure called vitrectomy maybe required to salvage your vision. Maintaining optimal blood sugar levels along with BP, haemoglobin and cholesterol, regular follow-ups, avoiding smoking and maintaining healthy body weight to improve insulin sensitivity help prevent this sight threatening complication of diabetes mellitus.

Dr. Arthi M
Rajan Eye Care Hospital

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