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Diabetic Retinopathy

Information on Daibetic Retinopathy

Diabetes Mellitus is a condition which impairs the body's ability to use and store sugar. The past two decades have seen an explosive increase in the incidence of Diabetes in India, which has the largest number of diabetics in the world today. The increased incidence of Diabetes Mellitus and its complications have been attributed to changes in life style caused by increased urbanization, high calorie diet, decreased physical activity and stress. Another cause for concern is that Diabetes Mellitus has been striking at an early age among the urban population. Diabetics are at a higher risk of developing blindness, getting a stroke, suffering from myocardial infarction, developing kidney disease or undergoing amputation. It is a common disease with serious ocular complications and one of the leading causes of blindness in the world. Diabetics are at high risk for eye complications, the most common being Diabetic Retinopathy. Certain studies have shown that the development of Diabetic Retinopathy depends greatly on the duration of Diabetes Mellitus. Other associated factors that increased the chances of this disease were hypertension, smoking & presence of renal diseases. Diabetes Mellitus does not just affect the retina. It has been found to promote cataract formation, and increased incidence of open angle Glaucoma, etc. Unfortunately, it is mainly the effect of Diabetes Mellitus on the retina that causes blindness.

What is Diabetic Retinopathy ?

It is a stage of the disease process in which the blood vessels in the retina are damaged and leak fluid or blood. It has been seen that 25 % of all diabetics develop this complication after 10 years of developing Diabetes and 50 %develop it after 20 years of developing diabetes. People with Type 1 Diabetes [Diabetes since childhood] are more likely to develop diabetic retinopathy at a younger age. Diabetics also have a higher incidence of cataract and glaucoma and those with poorly controlled blood sugar and blood pressure are at a higher risk of losing vision.

What are the symptoms of diabetic retinopathy ?

Early Diabetic Retinopathy usually has no symptoms. Gradual blurring of vision may occur if fluid leaks in the central part of the retina [the macula]. In late diabetic retinopathy [proliferative stage], new abnormal blood vessels begin growing on the surface of the retina or the optic nerve. These vessels have weak walls and leak blood into the retina and vitreous [jelly that fills most of the eye]. Presence of blood in the path, from where the light enters the eye, blocks vision.

How is diabetic retinopathy diagnosed ?

Complete eye examination is required for the detection of diabetic retinopathy. The retina of the eye is examined using an instrument called the indirect ophthalmoscope after dilating the pupils. If diabetic retinopathy is detected, a special test called Fluorescein Angiography may be performed where a dye is injected in the vein of the arm and serial photographs of the retina aretaken. Optical Coherence Tomography (OCT) is another test used for detection and evaluation of Diabetic Macular Edema(DME) which is swelling and fluid accumulation in the most important area of the retina.

How is diabetic retinopathy treated ?

The first step is that all diabetics must maintain strict control of blood sugar and blood pressure and follow a regular exercise regime and healthy diet. In early cases only regular follow-up may be necessary. More advanced cases require treatment to control the damage of Diabetic Retinopathy and improve sight in the form of lasers, injections or surgery.

I. LaserTreatment:

Here are two types of laser treatments done for DiabeticRetinopathy:

a) Focal Laser:

Focal laser is done for swelling of the macula due to leakage from damaged blood vessels. There is usually no pain from this laser and there will be some slight blurring of vision initially after treatment.

b) Peripheral Laser or Pan Retinal:

Photo coagulation (PRP): This type of laser is done for severe diabetic retinopathy which has developed new vessel for mationor bleeding into the vitreous gel. This type of laser may lead to loss of peripheral vision, decreased night vision and may be painful with the need to give an injection around the eye ball for anesthesia.

II. Vitrectomy Surgery:

In the event of the patient presenting with very advanced Diabetic Retinopathy, a microsurgical procedure known as Vitrectomy is recommended. Blood-filled vitreous gel of the eye is replaced with a clear solution to aid in restoring vision. Sometimes the retina may also be' detached. Vitrectomy surgery is thenperformed to reattach the retina.

III. Intraocular Injections:

Newer modility of treatment include use of intraocularinjections(AntiVEGF&Steroids) for diabetic macular edemas as a pre operative tool to reduce the incidence of bleeding during Vitrectomy Surgery. How to prevent visual loss in Diabetes ? Early detection of diabetic retinopathy and timely laser treatment is the best protection against loss of vision. Diabetics must have their eyes examined regularly. Our diabetic clinic is designed towards providing regular preventive care as well as fo I low—up for patients with established diabetic retinopathy. Additionally, all diabetics must maintain control of blood sugar and blood pressure and follow a regular exercise regime and healthy diet.

The Diabetic Retinopathy Treatment at HANS EYE HOSPITAL :

Diabetes needs regular follow-up since the condition can lead to a dramatic loss of vision if poorly treated orneglected.

Various factors govern the rate of progression of your condition. It is therefore necessary to review your eye condition periodically even after the present condition has been treated

The patients receive specialized care provided by our diabetic retina specialists.

At each visit to HANS EYE HOSPITAL, we check your vision & intraocular pressure, do a slitlamp biomicroscopy and perform a detailed retinal examination with dilated pupils using an indirect ophthalmoscope. We record images and maintain records of your eye condition for comparison on the following visit. We also monitor factors that control the progression of your eye condition such as diet, blood sugar levels, exercise, blood pressure etc.

We Perform special procedures like Fluorescein Angiography, Optical Coherence Tomography, Laser Photocoagulation and Ultrasonography, if required.

All diabetics must have their eyes examined regularly with dilated pupils. Juvenile diabetics must have their eyes examined at least once a yearafterthe age of12 years because diabetic retinopathy is rarely known to occur before puberty. Those with Diabetes at an older age must have the eye examination done once at the time of diagnosis and then at least every yearthereafter. If Diabetic Retinopathy has been diagnosed, they should have the eyes examinedas often as recommended by their eye doctor.

At HANS EYE HOSPITAL Your eye health is our prime concern. If you have any queries regarding Diabetic Retinopathy or its treatment, please feel free to contact us either personally or telephonically. Our team of doctors, counselors and staff will ensure that your experience of treatment of Diabetic Retinopathy, at our centre, is a leasant and memorable one.

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