Diabetic Retinopathy

Hi,

I am Dr. Tinku Bali Razdan, Ophthalmologist. Today I will be talking to you on diabetic retinopathy. It is a complication of diabetic mellitus which affects the eye. Diabetic patients would be surprised to know as they have 4 times more chance of becoming blind. This is something, most people do not know about. Where exactly does this happen? The eye is like a ball and behind the back part of the eye where the image is formed is called retina. This is effected by diabetes. Diabetes causes damage to blood vessels of the retina and this leads to visual repairment. Now a patient who has diabetes has no symptoms in the early stages. This will keep on progressing and may lead to blindness. As we all know that India is the diabetic capital of the world. So, it is important that we should know this vision-threatening complication so as to prevent vision loss and detect at the right time.

It is divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Non-proliferative diabetic retinopathy is an early stage where diabetes causes damage to the blood vessels of the retina. This vessel starts becoming leaky and fluids come out of them. This fluid can collect in the center of the retina which is called macula and cause swelling over there. This can cause blurring the vision. So, the early symptoms can be blurred vision, spots in front of your eye and these changes keep on progressing till the advanced stage which is called proliferative diabetic retinopathy. In this, new vessels start to form on the surface of the retina. These are very abnormal. They can also bleed inside the eye and cause severe visual loss. In the next stage, fibrous tissue can form which can cause a pull on the retina and cause retinal detachment which leads to very severe vision loss.

The important thing to remember that the early state of this may have no symptoms, whatsoever. So, it is very important that every patient of diabetes should go regular eye check-up at least once a year. Because in early stages you may have no symptoms. So, how do we see this damage? We have some special test. Remember, that you have to go to a retina specialist who is well trained. Your Dr will dilate your eye that is some drops in your eye. And then only Dr would be able to see inside the retina. Once it is detected, no treatment is required in an early stage. We just ask the patient to control sugar, blood pressure, get the hemoglobin checked and maintain. Your lipid profile is very important. Once you have an advanced form of diabetic retinopathy wherein there is swelling in your retina which is called macular edema the treatment is to give injections inside the eye.

This patient may require multiple such injections. And this is given at one-month intervals. Sometimes steroid injections may be required. Sometimes, laser treatment is required where a special light is put on the surface of the retina which causes bleeding blood vessels to shrink. In very advanced cases, when there is a lot of blood inside the eye then special surgery called vitrectomy may be needed to clear the blood. So, these are the various treatment modalities. But the most important thing is to remember that every diabetic patient needs an examination at least once a year. So, please do keep a regular check on your sugar, blood pressure, hemoglobin, lipid. Please go and see eye specialist once a year to protect your eyes from diabetes.

Thank You!