Thursday, March 16, 2023

Diabetes, as severe as it is, brings with it, a whole other dimension of diseases. Diabetes interferes with the body's ability to use and manage sugar(glucose). This disease is identified by too much sugar in the blood, which spreads damage throughout the body, including the eyes. And, one of them, is the infamous 'diabetic eye disease' or Diabetic retinopathy. Here, the damage occurs to the retina due to the adverse affects of uncontrolled diabetes, which may eventually lead to blindness.

What is Diabetic Retinopathy?

When changes occur in the blood vessels of the retina, whether they get damaged, may leak blood, or grow feeble new vessels, it leads to an impaired vision. Regular diabetes eye test is necessary in order to identify the disease at an earlier stage. Diabetic retinopathy leads to chronological damage to the retina, the light-sensitive lining at the back of the eye, and hence, is considered an alarming sight- threatening complication of diabetes.


The earlier the detection of a disease, the earlier it can be cured. And the case with diabetic retinopathy is the same, comprising of two stages:

1. Non-proliferative diabetic retinopathy (NDPR):

Early stage of the disease, where the body may show mild symptoms,or not show any symptoms at all. Another name for macular edema, a condition where the blood vessels in the retina get weakened and start developing leaks. The blood and fluids leak from the retinal blood vessels, and get deposited into the retina, which leads to retinal swelling. This swelling in the central part of the retina, called macula, in turn, results in reduced or blurred vision.

2. Proliferative Retinopathy (PDR):

The advanced form of the disease, where the retina is deprived of oxygen, due to circulation issues. It refers to the alterations that occur when new, abnormal blood vessels start growing in the retina, and the vitreous, the gel-like fluid that fills the back of the eye. Since, these vessels include weaker walls, they end up breaking or bleeding, ultimately clouding the vision.

How common is Diabetic retinopathy?

The frequency of diabetes, is ever-increasing all over the world, as a result, the prevalence of diabetic retinopathy is also expected to increase drastically. It is deemed as a leading cause of the new cases of blindness prevalent amongst the adults. According to the Canadian Diabetes Association, retinopathy affects 23 percent of people with type 1 diabetes, and 14 percent of insulin-dependent people with type 2 diabetes. Lack of awareness, is the key factor that puts people in a grave danger. Where people with type 1 diabetes should have annual screenings for the diabetes eye test, at least after 5 years of the dawn of their disease, the ones with type 2 diabetes should get an examination, at the time of diagnosis itself, and yearly examinations at later time. Currently, only about 60% of people with diabetes have yearly screening for diabetic retinopathy.

The prevalence rate for retinopathy for all adults with diabetes worldwide, is estimated at 34.6% (93 million people), and the one for vision-threatening diabetic retinopathy(VTDR) is 10.2% (28 million people).

A major risk factor associated with the intensification of diabetic retinopathy, is the duration of diabetes. Gradually, after 5 years, approximately 25% of type 1 patients have retinopathy. After 10 years, 60%, and in 15 years, 80% of people may have retinopathy. Whereas, in the type 2 diabetic patients, the ones in the age of 30-35, who have been living with the disease for over 5 years, it is estimated that 40% of insulin-dependent patients, and 24% of those not taking insulin, have retinopathy. If diabetes has been prevalent for over 18 years, the rates increase to 84% and 53% respectively.

Vision restoration, cure, and treatments

Unfortunately, retinopathy is a chronic disease, and hence, cannot be cured. But, early detection of the disease, along with effective treatments, including laser treatments, and vitrectomy surgery, can act as the factors to preserve vision.

Laser Treatments

It is the most common and effective treatment for diabetic retinopathy. Laser treatments, are used for both, reduction of macular edema, as well as, for abnormal blood vessel growth. The laser scars the retina, to stop the creation of new blood vessels, and suppress the ones that are already existing. The laser photocoagulation is also used to block the leaking blood vessels, that may damage the macula area of the eye. The foremost objective of the laser surgery is to prevent any further loss of vision, and not restore the vision that is already lost. Laser surgery maybe performed in the ophthalmologist's office, or on an outaptient basis in a clinic.

Vitrectomy Surgery

This comes to picture, when a hemorrhage occurs, and there is severe loss of vision, or when the retina is in the danger of detaching from the back of the eye. In the case of proliferative diabetic retinopathy, vitrectomy surgery is recommended to successfully restore vision. Retina repair is important, in case the tissue has detached the retina from the back of the eye. Surgery is crucial, to avoid blindness or severe loss of vision.

Medicated eye drops, protective eye patch, are used as measures to safeguard the eye, after the completion of surgery, and safe return at home.

Factors including, diabetes control, regular check-ups, and early detection of the disease; play the most important role in preventing vision loss, or damage to the eye. The goal of any treatment or safeguard measure is to prevent the further progression of the disease. And, following the doctor's advice is an essential part of coping with the same.

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Image by Paul Diaconu from Pixabay 

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