Diabetes is a metabolic disorder in which chronic rise in blood sugar levels affect the Heart, Nerves & Eyes.
Increased incidence of diabetes has been attributed to changes in lifestyle caused by increased urbanization, high calorie diet, decreased physical activity & stress.
Diabetic Retinopathy occurs when there is a slow gradual damage to blood vessels then either start to leak or they eventually get blocked
Many trials done show that “better control of blood sugar levels slow the onset & progression of diabetic retinopathy. ”Also well controlled “Blood pressure & Cholestrol” can reduce the risk of vision loss.
No symptoms are experienced in early& intermediate stage.Blood vessels damaged from diabetic retinopathy can cause vision loss in following ways
Treatment :
The following modalities are usually advised :
1. Laser Photocoagulation :
Scatter laser treatment involves placing 1000 to 2000 burns in the area of retina away from centre (macula) so as to shrink the abnormal blood vessels.
Focal laser treatment is used to treat macular edema (swelling) whereby small laser burns are placed in the area of leakages. These burns slow the leakage & reduce the amount of fluid in centre of retina. Laser treatment can reduce the risk of blindness by 90%. However laser treatment cannot restore vision that has been already lost. It mainly helps to stabilise the exiting vision.
2) Intra viteral injections : They are an adjunct to laser. Helps avoid repeated laser. Injections show dramatic reduction in macular edema as well as help in resolving the bleedings.
New generation injections are so effective that sometimes they have come to become the first line of treatment.
3) Vitrectomy (Retinal Surgery) : If the bleeding is severe or if there is a traction (pull) on the retina, Vitrectomy helps in clearing the blood, stabilising the retina & reducing the chances of blindeness.
Please do note that multiple sitting of laser and / or injection may be required in combination / separate, depending upon your disease progression. It is well documented that the above treatment, done on timely basis, can help prevent visual loss.
Ans: Diabetes is a chronic disease, the longer you suffer from it (in terms of years) & more the fluctuations you would have had in sugar level, the more the retinal blood vessesl get weak and the damage intiates. If you start to control your sugar level after the damage has already occured, then it takes time for the weak blood vessels to heal. So you may not see immediate benefit of sugar control but it will definitely help your blood vessels to heal & prevent progression over time
Ans: Depending on your retina condition, your opthalmologist may suggest 1 to 6 sittings. Event after these sessions, you will need periodic eye evaluations.
Ans: Injection have improved the outcome of diabetic retinopathy in a significant way. But the action of injection is short lived, so repeat injections are required till your retinopathy settles down. Injections also help to reduce the necessity of frequent laser.
Ans: In today's era of advancements in retinal treatment, we are able to achieve satisfactory results. It is advisable that the patient complies with the following.
1) Regular eye checkup as advised
2) Good control of diabetes along with control of blood pressure, cholesterol, cardiact & renal diseases.
3) Maintain a healthy lifestyle with diet and exercise therby reducing / maintaining one's weight.