AURANGABAD: "India is known as the diabetic capital of the world as nearly 25% of the world's diabetic patients are Indians. Diabetes can cause various eye problems ranging from lid styes, cataract, glaucoma and various retinal vascular problems, the most important and common being the diabetic retinopathy, said ophthalmologist and vitreoretinal Swapnil Dongaonkar, adding, "Retinal detachments in diabetic patients can cause blindness if left untreated."
"Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina. Too often, patients are unaware that a retinal detachment has formed. The macula may be still attached and, though misleading, the vision is still quite useful. At other times, patients may have lost significant vision in one eye and retain good vision in the other. Many patients are unaware of significant vision loss when only one eye is affected," he said.
Dongaonkar said, "Due to the growing incidence of diabetes and the increased life expectancy in the recent years, the prevalence of diabetic retinopathy and its attendant morbidity is an emerging health problem."
Manoj Saswade, surgeon and vitreoretinal, said, "Of diabetic patients, nearly 20% develop diabetic retinopathy. A third of people with diabetes never know that they have diabetes; just two-thirds of diabetics go for medical attention. Among the population of diabetics, only a miniscule percentage is referred for regular eye check-ups."
The head of the department of Ophtalmology, Government Medical College and Hospital, Bhaskar Khaire said, "Diabetic retinopathy is an important cause of blindness in the working age group. A diabetic is 25 times more likely to go blind. Diabetes is a serious disorder that can cause blindness, heart disease, kidney failure, and amputations. But by taking good care of yourself through diet, exercise, and special medications, you can control diabetes. And there is more good news; diabetes related visual loss due to diabetic retinopathy can be treated before visual loss occurs."
While explaining the risk factor of diabetic retinopathy Dongaonkar said, "It is advisable for type 1 patients to have retinopathy screening within five years of disease development and for type 2 patients to screen themselves for retinopathy at the time of diabetes detection and later screening should be done after every six months."
Informing about the signs and symptoms of diabetic retinopathy, he said, "In the early stages of the disease the person does not notice any symptoms, hence does not visit the eye doctor for a screening test. By the time symptoms are noticed, the disease is fairly advanced. Some people, however, notice reduced or foggy vision, distorted vision, black spots (floaters) in front of their eyes. In the advanced stage, there may be sudden loss of vision or bloody curtain like appearance in visual field."
Diabetic retinopathy can be detected through various methods of eye examination such as visual acuity test, pupil dilation, ophthalmoscopy and fluorescein angiography.
Dongaonkar said, "Diabetic retinopathy can be treated through three main modalities - Green Laser treatment: this helps decrease retinal edema helping to decrease recurrent retinal bleeding. It is not helpful in improving vision but stabilising it. Second is Intravitreal injection: helps reduce retinal bleeding and third is Vitrectomy: this is a surgical procedure used in advanced stages of disease. It helps in clearing non resolving haemorrhage and managing retinal detachment complication due to advanced retinopathy.