Diabetic Retinopathy is a common complication of Diabetes mellitus which can happen in patients with both Type I and Type II diabetes. The duration of the disease and poor glycemic control are directly associated with the development of this condition. It causes the blood vessels in your retina to swell in the initial phase, eventually leading to occlusion of the blood vessels.
Diabetic Retinopathy Symptoms
Diabetic Retinopathy does not show any symptoms and signs in the early stages.
As the condition progresses it can lead to symptoms of blurred vision or diminished vision,
Which over time may eventually lead to floaters or black spots in vision, dark areas in the visual field and even complete loss of vision.
Diabetic Retinopathy Causes
Any person with diabetes can develop diabetic retinopathy. The main cause of diabetic retinopathy is damage to the blood vessels network that provides nourishment to the retina. Due to high blood glucose levels, the vessels get weak, damaged or grow abnormally and restrict the blood flow to the retina.
The risk of diabetic retinopathy is higher in cases of:
- Poor control of the sugar levels
- Long duration of diabetes
Diabetic Retinopathy Diagnosis
Your ophthalmologist can diagnose Diabetic retinopathy during a comprehensive dilated eye examination. The comprehensive diabetic eye exam includes:
- Visual acuity testing: This test measures your ability to see at various distances.
- Tonometry: With this test, your doctor will check the pressure inside the eye.
- Pupil dilation: The eye care professional will place drops to dilate or widen the pupil. This allows the eye doctor to examine the optic nerve and the retina.
- Optical coherence tomography (OCT) and OCT-Angiography: In this technique, light waves are used to capture the detailed images of retinal tissue. It provides an in-depth analysis of the retinal structure and vascularity.
- Fluorescein angiogram: It is used in cases of severe diabetic retinopathy to look for leaky or damaged blood vessels.
Diabetic Retinopathy Treatment
Careful management of the systemic diabetic status is the best way to slow down the development and progression of this condition. As the condition advances to a level wherein the risk of bleeding inside the eye is high, laser treatment is offered to the patient to diminish this risk of sudden visual loss. This method does not improve vision but prevents further deterioration.
In some cases wherein the fluid accumulation happens in the central area of the retina; a condition referred to as macular edema, treatment consists of injections that are given in the eye. These injections help to control and remove the fluid leading to an increase in visual acuity.
Diabetic Retinopathy Surgery
Surgery for diabetic retinopathy is in the form of vitrectomy. Vitrectomy is performed when laser treatment is ineffective or in case the condition is so advanced that laser itself cannot stabilise the clinical condition. In this procedure, with the patient under local anaesthesia, we remove the clouded vitreous gel from within the eyeball. It is then replaced with a clear liquid or gas. Any scar tissue that may be tugging on the retina or blood in the vitreous is also removed.
Diabetic Retinopathy Precautions
The most important and modifiable risk factor in the progression of diabetic retinopathy is the control of sugar levels. This associated with improved control of blood pressure and cholesterol and avoidance of smoking will help in slowing the progression of the condition. Following laser treatment, it is advisable to avoid lifting heavy weight for the next two weeks so as to reduce the chances of repeated bleeding in the eye.
Diabetic Retinopathy Risks
Uncontrolled diabetes and unmonitored diabetic retinopathy can lead to a sudden visual loss, glaucoma and ultimately a painful blind eye.
Diabetic Retinopathy Recovery
Recovery following surgery for the condition can vary from a few weeks to months. It depends upon the initial clinical condition at presentation. Patients with a less advanced form of the disease notice a much more significant improvement in vision as compared to people with more advanced disease or retinal detachments.
MS (2012-2015): Government Medical College, Chandigarh Vitreo-Retina Surgical Fellowship (2016-2018): Aravind Eye Hospital, Tirunelveli.
Special Interests: Retinopathy of Prematurity, Retinal Detachment surgery and Diabetic Retinopathy
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