Diabetic Retinopathy
1.
What is diabetic retinopathy? The human body does not use and store sugar properly in diabetes mellitus.
High blood sugar levels can damage the blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send the images to the brain.
The damage to the retinal vessels is referred to as diabetic retinopathy.
2.
Which patients are at risk of developing diabetic retinopathy? All diabetic patients are at risk of developing diabetic retinopathy.
The longer the patient has diabetes and the more uncontrolled it is, the greater the risk.
The presence of hypertension, nephropathy, high cholesterol levels and anemia add to the risk.
3.
Can it cause blindness? Yes, severe loss of vision can occur due to bleeding within the eye or a retinal detachment (detachment of the sensory part of the eye).
Moderate loss of vision can occur due to edema (swelling) of the retina.
4.
Can it be detected early? A simple dilated eye examination by a retina specialist can help to determine the amount and severity of the disease.
5.
Can diabetic retinopathy be prevented? Diabetic retinopathy can be slowed down if systemic parameters like blood sugar levels, blood pressure, lipid profile (cholesterol and triglycerides), kidney function tests and hemoglobin levels are kept under control.
You should be under the supervision of a physician for the control of blood sugar levels.
.
6.
What are the symptoms of diabetic retinopathy? • Patients may remain free of symptoms in the early phases of the disease.
• Blurred vision.
• Sudden loss of vision in one eye.
• Black spots moving in front of the eye.
• Distorted central vision.
• Abnormal patterns in the field of vision.
7.
Do all patients present with these symptoms? Many people with severe, vision-threatening diabetic retinopathy have no symptoms! Regular ophthalmic examinations are crucial to obtaining treatment before it is too late! 8.
What all test are available to diagnose diabetic retinopathy? • Dilated retinal examination.
• Digital Fluorescein Angiography (FFA or DFA).
• Optical Coherence Tomography (OCT).
• Ophthalmic ultrasound.
9.
What is fluorescein angiography? This is a magnified photography of the retina wherein a special dye (Flurescein) is injected into the arm.
When dye injected in the arm it (dye) takes only 8 to 12 seconds to reach in the retina.
Pictures are taken as the dye passes through the blood vessels in the retina.
The test allows the doctor to identify any leaking blood vessels and recommend treatment.
It helps to classify the condition and to record changes in the retinal blood vessels.
10.
What is Optical Coherence tomography? This is a powerful, non invasive diagnostic imaging technology that provides high resolution, cross sectional images of the retina.
It gives the exact amount of retinal thickness, the fluid collection; the layers involved; any traction on the retina etc which is of great significance in planning treatment.
OCT helps in planning treatment with laser, intravitreal injections or microsurgery.
11.
How is Ophthalmic Ultrasound useful in patients of diabetic retinopathy? The ultrasound of the eye is very useful in planning surgery for diabetic patients especially when they have cataracts, lot of hemorrhage and visibility of the retina is poor.
12.
What treatments are available? Laser is the most widely used treatment modality for diabetic retinopathy.
It can help to prevent a bleed in the eye in cases of proliferative diabetic retinopathy.
Here the laser acts by regressing the new blood vessels.
Studies have shown that laser in these cases reduces the risk of severe vision loss by 50%.
Laser is also used in eyes which have swelling in the centre that is macula area.
It has to be properly timed.
However it cannot usually restore vision lost due to retinal damage.
Intraocular injections of steroids and anti VEGFs (Avastin, Lucentis)-Latest treatment-help in reducing swelling of the retina especially cases which are not treatable with laser treatment.
Microsurgery (vitreoretinal surgeries).
Advanced cases with non resolving vitreous hemorrhage (Bleeding in the eye) and retinal detachments require microsurgery.
Highly advanced technology, wide angle viewing system, sophisticated instrumentation and skilled surgeon can make all the difference to achieve visual results in a large number of advanced cases also.
13.
I am diabetic but it is now under control.
Do I also need an eye examination? Yes, every diabetic is a potential candidate for diabetic retinopathy.
There are no symptoms at the initial stages.
Periodic eye examination with dilated pupils is the only way to detect early disease and prevent further deterioration of vision.
Important facts to remember: • Diabetics are twice as likely as non-diabetics to develop eye problems.
The most common eye complication in diabetes is diabetic retinopathy; other complications are cataract and glaucoma.
• Fifty percent of diabetics develop some degree of diabetic eye disease.
• The risk of blindness is 25 times higher in diabetics than in non-diabetics.
• Early detection and timely treatment of diabetic eye disease significantly reduces the risk of vision loss.
• Diabetic retinopathy is often symptomless in the early stages.
Since only an ophthalmologist can detect early signs of diabetic retinopathy, all diabetics should have their eyes examined at least once every year.
What is diabetic retinopathy? The human body does not use and store sugar properly in diabetes mellitus.
High blood sugar levels can damage the blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send the images to the brain.
The damage to the retinal vessels is referred to as diabetic retinopathy.
2.
Which patients are at risk of developing diabetic retinopathy? All diabetic patients are at risk of developing diabetic retinopathy.
The longer the patient has diabetes and the more uncontrolled it is, the greater the risk.
The presence of hypertension, nephropathy, high cholesterol levels and anemia add to the risk.
3.
Can it cause blindness? Yes, severe loss of vision can occur due to bleeding within the eye or a retinal detachment (detachment of the sensory part of the eye).
Moderate loss of vision can occur due to edema (swelling) of the retina.
4.
Can it be detected early? A simple dilated eye examination by a retina specialist can help to determine the amount and severity of the disease.
5.
Can diabetic retinopathy be prevented? Diabetic retinopathy can be slowed down if systemic parameters like blood sugar levels, blood pressure, lipid profile (cholesterol and triglycerides), kidney function tests and hemoglobin levels are kept under control.
You should be under the supervision of a physician for the control of blood sugar levels.
.
6.
What are the symptoms of diabetic retinopathy? • Patients may remain free of symptoms in the early phases of the disease.
• Blurred vision.
• Sudden loss of vision in one eye.
• Black spots moving in front of the eye.
• Distorted central vision.
• Abnormal patterns in the field of vision.
7.
Do all patients present with these symptoms? Many people with severe, vision-threatening diabetic retinopathy have no symptoms! Regular ophthalmic examinations are crucial to obtaining treatment before it is too late! 8.
What all test are available to diagnose diabetic retinopathy? • Dilated retinal examination.
• Digital Fluorescein Angiography (FFA or DFA).
• Optical Coherence Tomography (OCT).
• Ophthalmic ultrasound.
9.
What is fluorescein angiography? This is a magnified photography of the retina wherein a special dye (Flurescein) is injected into the arm.
When dye injected in the arm it (dye) takes only 8 to 12 seconds to reach in the retina.
Pictures are taken as the dye passes through the blood vessels in the retina.
The test allows the doctor to identify any leaking blood vessels and recommend treatment.
It helps to classify the condition and to record changes in the retinal blood vessels.
10.
What is Optical Coherence tomography? This is a powerful, non invasive diagnostic imaging technology that provides high resolution, cross sectional images of the retina.
It gives the exact amount of retinal thickness, the fluid collection; the layers involved; any traction on the retina etc which is of great significance in planning treatment.
OCT helps in planning treatment with laser, intravitreal injections or microsurgery.
11.
How is Ophthalmic Ultrasound useful in patients of diabetic retinopathy? The ultrasound of the eye is very useful in planning surgery for diabetic patients especially when they have cataracts, lot of hemorrhage and visibility of the retina is poor.
12.
What treatments are available? Laser is the most widely used treatment modality for diabetic retinopathy.
It can help to prevent a bleed in the eye in cases of proliferative diabetic retinopathy.
Here the laser acts by regressing the new blood vessels.
Studies have shown that laser in these cases reduces the risk of severe vision loss by 50%.
Laser is also used in eyes which have swelling in the centre that is macula area.
It has to be properly timed.
However it cannot usually restore vision lost due to retinal damage.
Intraocular injections of steroids and anti VEGFs (Avastin, Lucentis)-Latest treatment-help in reducing swelling of the retina especially cases which are not treatable with laser treatment.
Microsurgery (vitreoretinal surgeries).
Advanced cases with non resolving vitreous hemorrhage (Bleeding in the eye) and retinal detachments require microsurgery.
Highly advanced technology, wide angle viewing system, sophisticated instrumentation and skilled surgeon can make all the difference to achieve visual results in a large number of advanced cases also.
13.
I am diabetic but it is now under control.
Do I also need an eye examination? Yes, every diabetic is a potential candidate for diabetic retinopathy.
There are no symptoms at the initial stages.
Periodic eye examination with dilated pupils is the only way to detect early disease and prevent further deterioration of vision.
Important facts to remember: • Diabetics are twice as likely as non-diabetics to develop eye problems.
The most common eye complication in diabetes is diabetic retinopathy; other complications are cataract and glaucoma.
• Fifty percent of diabetics develop some degree of diabetic eye disease.
• The risk of blindness is 25 times higher in diabetics than in non-diabetics.
• Early detection and timely treatment of diabetic eye disease significantly reduces the risk of vision loss.
• Diabetic retinopathy is often symptomless in the early stages.
Since only an ophthalmologist can detect early signs of diabetic retinopathy, all diabetics should have their eyes examined at least once every year.
