Relevance of Diabetes to eye diseases

India is the country with the highest incidence of diabetes in the world. Diabetes is closely linked to eye problems and is capable of causing blindness. Hence timely diagnosis and treatment is essential. It is strongly recommended that diabetic patients have their eyes checked up regularly once in every six months or as advised by the ophthalmologist. Diabetic retinopathy is the broader term which collectively refers to all diseases of the retina caused by diabetes. The retinal damages may include macular degeneration, retinal detachments, bleeding of the eye, macular holes, retinitis pigmentosa, etc. 

Stages of Diabetic Retinopathy

There is no permanent cure for Diabetic Retinopathy to date.  But still sophisticated and effective treatment methods have evolved over time to safeguard vision by preventing further progress of disease.

The disease progresses in two stages.

i. Nonproliferative Retinopathy

It marks the initial stage of retinopathy when blood vessels in the retina get affected and form pouches. Most diabetic patients who suffer from diabetes for twenty years shall exhibit some signs of nonproliferative diabetic retinopathy. Although treatment is not generally required at this stage, macular edema demands prompt treatment to safeguard vision. 

Macular edema – A portion of the retina specialized for sharp vision, writing and colour differentiation is called the macula. Over a course of time, the macula of an individual with diabetes swells with fluid. This condition is termed as macular edema which may result in loss of vision if left unattended.

ii. Proliferative Retinopathy

At this stage the blood vessels are blocked and subsequently leak. It is a serious stage of retinopathy. In certain cases, new blood vessels grow, in an abnormal way, on the boundary of the retina.

Symptoms

No symptoms manifest in the early stage of Diabetic Retinopathy. The symptoms that show up in the proliferative retinopathy stage are as below:

  1.    Vision that varies irregularly
  2.    Visual perception of slender threads, black spots or spider webs. 
  3.    Blurry and misshaped vision, i.e., visualisation of misshaped images 
  4.    Double vision
  5.    Eye pain caused by secondary glaucoma. Secondary glaucoma is an eye disorder that develops from well known causes such as diabetes, cataract, serious eye injuries, tumour etc.
  6.    Complete loss of vision

Treatment

Lasers are extensively used in treatment of diabetic retinopathy. The laser beam can slow down or prohibit the progression of the disease and stabilise vision. Occasionally an injection (Anti-VEGF) is given in the eye. Retinal scan through Optical Coherence Tomographer (OCT) is essential to measure the extent and spot the locations of damage. This shall be followed by Retinal lasers or Intra-vitreal injections.