Diabetic Eye Disease
Diabetic eye disease is a cluster of eye problems that diabetics may encounter as a result of complication of diabetes. All these eye problems can lead to significant vision loss or even blindness.
Diabetic eye disease may include:
Diabetic retinopathy which is a damage to the blood vessels in the retina, the most common diabetic eye disease and a major cause of blindness in adults. It is caused by changes in the blood vessels of the retina.
Cataract which is clouding of the eye’s lens develops at an earlier age in people with diabetes.
Glaucoma is an increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.
In some people with diabetic retinopathy, blood vessels may swell and leak fluid causing swelling or oedema of retina. In some other people, the growth of abnormal new blood vessels on the surface of the retina leads to haemorrhage or bleeding in the back cavity of eye known as vitreous haemorrhage. A person with diabetic retinopathy, initially may not notice changes to his / her vision. But gradually, diabetic retinopathy can worsen resulting in vision loss. Diabetic retinopathy is all the more dangerous as itusually affects both eyes.
Points to note
- Often there are no symptoms in the early stages of the disease, nor is there any pain. A comprehensive dilated eye exam at least once a year can help detect whether one has the disease or not.
- Macular edema refers to the condition in which blurred vision may occur when the macula—the part of the retina that provides sharp central vision—swells from leaking fluid.
- If new blood vessels grow on the surface of the retina, they can bleed into the eye and block vision.
Treatment of Diabetic Retinopathy:Macular oedema is treated with laser surgery and if the need arises with intravitreal injections.
Focal Laser/Grid Laser: The doctor places up to several hundred small laser burns in the areas of retinal leakage surrounding the macula to slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed.
A patient may need focal laser surgery more than once to control the leaking fluid. If a patient has macular oedema in both eyes and require laser surgery can be done simultaneously,
Focal laser treatment is effective stabilizing vision. It actually reduces the risk of vision loss by 50 percent. In a small number of cases, if vision is lost, it can be improved.
Proliferative retinopathy is also treated with laser surgery; the procedure is called scatter laser photocoagulation which helps to shrink the abnormal blood vessels. The eye care specialist places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, to shrink the abnormal blood vessels. Because a high number of laser burns are necessary, the completion of treatment usually requires four or more sessions. Although one may lose some of one’s side vision, scatter laser treatment can save the rest of the sight. Scatter laser treatment may cause slight reduction in your colour vision and night vision.
Scatter laser treatment works better before the fragile, new blood vessels have started to bleed (High Risk Proliferative Diabetic Retinopathy). That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding.
In case one suffers from advanced retinopathy and the bleeding is severe, one may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the centre of the eye. If you have diabetes gets a comprehensive dilated eye exam at least once a year. Be warned:
- Proliferative retinopathy can develop without symptoms.You are at high risk of vision loss at this advanced stage.
Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy.
- You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss.
- Your eye care specialist can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss.
- If one has diabetic retinopathy, one may need a vision assessment more often. With timely treatment and appropriate follow-up care, people with proliferative retinopathy can reduce their risk of blindness by 95 percent.
- In order to prevent the onslaught of diabetic retinopathy, diabetics muststrictly control their levels of blood sugar, blood pressure, and blood cholesterol.
A dilated eye exam is the most effective way to diagnose a diabetic retinopathy. At Nayanjoti Eye & Laser Centre, advanced diagnostic and treatment tools are in use to cure diabetic retinopathy