Retinopathy – A severe ramification of diabetes

Diabetes has seen a surge in the recent past, however, the preventable blindness caused by the disease too is on the rise. Having more than normal blood sugar levels may not be a direct cause of blindness, but it does increase the chance of developing serious eye conditions like diabetic retinopathy, which can lead to permanent loss of vision over time. According to the reports, Over 422 million people worldwide suffer from diabetes, especially in low and middle-income countries. It is the leading cause of death worldwide, accounting for 1.5 million deaths yearly. It is also responsible for 2.6% of global blindness. 

According to Dr. Mohanraj of Dr. Agarwals Eye Hospitals, “One in 4 working adults (early ’20s to early 60s) have undiagnosed diabetes. Very often, vision problems lead to the discovery of the condition. It’s important to be aware of the symptoms of diabetic eye disease. If it is left untreated, these can even lead to complete vision loss.”

Risk factors involved in Diabetic Retinopathy are: 

• Longer duration of diabetes, 
• Poor control of blood sugar
• High B.P
• High Cholesterol
• Pregnancy. 

The initial stages do not have any symptoms. As the disease progresses blurred vision, spots floating in vision, dark or empty areas of vision, sudden visual loss can occur when the disease is mild to moderate it is called non-proliferative diabetic retinopathy {NPDR}and the advanced stage is called Proliferative diabetic retinopathy [PDR].”

Dr. Mohanraj adds, “In NPDR stage blood vessels of the retina become weak and start leaking fluid and blood into the retina. When fluid leaks into the central portion of the retina called the macula, which is responsible for central vision patient can present with a  loss of vision. In advanced stages, blood vessels get blocked and as an attempt to restore lost blood supply eye forms new blood vessels. These vessels are very fragile, easily leak fluid and blood into the retina as well as into the vitreous a jelly-like substance that fills the center of the eyeball. If left untreated membrane and scar tissue are formed which pulls the retina away and causes a retinal detachment.”

Diabetic retinopathy can be clinically diagnosed by dilating the pupil using drops and examination of the retina. If changes are detected tests like FFA and OCT are done to assess the severity and extent of the disease. Treatment includes a laser for damaged vessels. If swelling in the retina is observed monthly intravitreal anti-VEGF injections are given in the eye till it reduces. In advanced stages, surgeries are performed.

Dr. Mohanraj further concluded, “Risk of developing retinopathy can be reduced by certain lifestyle modifications like eating a healthy diet, regular exercise, taking regular medications and regular monitoring of blood sugar level along with strict control on Cholesterol and BP. Last but not least is regular eye screening including retinal examination every 6 months. Early detection

of retinopathy and treatment can help prevent severe visual loss and reduces the need for surgery.”