Diabetic retinopathy


From my previous blog,you might have read about the deleterious consequences of diabetes on our body. I would to like to explain further about the effect it has on our eyes.

Diabetes has a myriad of ocular manifestations like blepharitis, stye, dry eyes, mucormycosis, cataract and diabetic retinopathy.
As each of these conditions is a topic by itself, in this blog I will be focussing on diabetic retinopathy alone.
What is diabetic retinopathy?
High blood glucose in diabetes damages blood vessels in your body, eyes are no exception. This leads to leakage predominantly in the small blood vessels of retina.Fluid gets collected in the central area of retina called macula, causing blurry vision. Besides, longstanding diabetic retinopathy can induce growth of new vessels in retina due to decreased oxygenation. This in turn can pave way for bleeding inside eye,secondary glaucoma, scarring or detachment of your retina.
What are the risk factors?
  • Undoubtedly, poor control of blood sugars
  • Long standing diabetes (40% chance if disease duration more than 15 years)
  • Have coexisting hypertension and hyperlipidemia.
  • Pregnancy
  • Smoking

Are there any symptoms?

Not really, you won’t have any symptoms until the advanced stage. So it is advised to undergo yearly retinal screening by your ophthalmologist for an early detection of the disease.
If you are a diabetic, consult your doctor immediately if you experience any of these symptoms
  • Blurry vision
  • Seeing black specks or cobweb like objects in front of your eye
  • Loss of vision
  • Painful red eye
What to do next if you are diagnosed with diabetic retinopathy?
The management of the condition depends on its severity
  • If you have mild disease you may be advised to keep blood sugars in check and follow up yearly
  • If you have moderate disease, usually associated with fluid leakage in the central part of retina, there are few treatment options as follows:

-Anti Vascular endothelial growth factor (Anti VEGF) injections into your eye namely Lucentis, Razumab, Eyelea.Minimum 3 cycles are required.

-Corticosteroid injections like Ozurdex.
-Lasers namely focal laser, more recently subthreshold laser.
  • In case of severe disease characterised by growth of new vessels into retina,bleeding inside eye, secondary glaucoma or retinal detachment,few treatment options are available, though the prognosis is dismal

Panretinal photocoagulation laser, which improves oxygenation to retina and shrinks blood vessels.

-Anti VEGF injections, serve as a supplement to laser

-Vitrectomy for non clearing bleeding inside the eye.
-Retinal detachment surgery
-Antiglaucoma medications or glaucoma drainage device.
In all advanced cases, cataract removal must be done prior to any retinal procedure.
I hope you will find this information useful!!

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