Friday 25 September 2020

Diabetic Retinopathy - What is it and how is it treated?

Retinopathy refers to any disease that affects the human retina, i.e. the innermost layer of the eye. And, when diabetes is that disease, it is called Diabetic Retinopathy. Any person who has Type 1 or Type 2 diabetes or has been a long term diabetic with uncontrolled blood sugar, is at high risk of being afflicted by retinopathy. 


There usually are no early stage symptoms, But if it worsens, the following can occur:

  • Double vision or blurry distorted vision.
  • Retinal blood vessels start bleeding into the eye, causing dark floating spots.
  • Pain due to damage to the optic nerve, caused by high blood pressure.
  • Total vision loss.

It can also led to the following very serious eye conditions:

  • Diabetic Macular Edema (DME) - Edema means a swelling caused by an injury or inflammation. This happens when retinal blood vessels start leaking fluid causing a swelling, which leads to blurry vision. 
  • Neovascular Glaucoma - when abnormal growth of blood vessels block the fluid from draining out of the eye, leading damage to the nerves.
  • Retinal Detachment - scarring on the back of the eye pulls the retina back from the eye in a condition called tractional retinal detachment.

Checking & Diagnosis:

This starts with a dilated eye exam, where eye drops are used to dilate or widen the pupil of the eye, followed by Vision Acuity Test to check clarity of vision; Vision Field Test to check side vision; Muscle Function Test to check the eye muscles; Pupil Response Test to check pupil’s response to light and a Tonometry Test to check eye blood pressure. If severe DME is suspected, a Fluorescein Angiogram would be advised. Here a harmless dye is injected into the blood allowing photographs to be taken of the retinal blood vessels.

Treatment: 

Injections: in DME patients a protein called VEGF is known to increase blood leakage and swelling. Injecting anti-VEGF medication blocks VEGF and improves the condition.

Laser Treatment: Here lasers are used to reduce swelling, shrink blood vessels to stop leakage.

Eye Surgery / Vitrectomy: this is advised when there is a lot of bleeding, scarring or to remove and replace the vitreous, i.e. the gel that fills the human eye with a special gas or silicone oil. It is also used to reattach displaced retina. 

Every diabetic is at risk of suffering Diabetic Retinopathy, with Type 1 and Type 2 patients being at highest risk. For a diabetic, regular eye exams are highly recommended, as early diagnosis can stop the damage and prevent blindness.


Blog Reviewed By: Dr. Lalit Kumar
Mail Us: amrithospitalchennai@gmail.com 

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