Diabetes and Eyes by Dr Parul Sharma

Diabetes can be of how many types? What are the key differences between them?
Diabetes is of two types, namely Type 1 diabetes and Type 2 diabetes.
  • Type 1:Also called Insulin Dependent Diabetes Mellitus (IDDM), Type 1 diabetes is marked by little or no production of insulin in the body because of an overactive immune system. Children and young individuals are most prone to this type. Those affected by it need to inject insulin daily.
  • Type 2:In Non-insulin Dependent Diabetes Mellitus (NIDDM), the insulin produced in the body is either too less or is not used adequately. Individuals aged above 40 are likely to fall prey to this type. Also, overweight individuals are at a greater risk of developing Type 2 diabetes. Medication and diet prescribed by a skilled physician can help controlling it.
How is diabetes and eye diseases related?
It has been clinically proven that uncontrolled sugar levels in the body or prolonged diabetes may affect the health of an individual’s eyes. It can lead tomnay eye ailments, such as diabetic retinopathy, glaucoma, and cataract. However, every diabetic patient may not necessarily develop an eye problem.

Are annual eye examinations mandatory for every diabetic patient?
Diabetes can be a major cause of sight loss. Diagnosing and controlling diabetes on time is crucial in order to prevent a number of eye diseases. Only thorough eye examinations every year can help detecting symptoms that may not be apparent.

What are the measures that can be taken to prevent sight loss due to diabetes?
Keeping a strict check on blood pressure and blood sugar levels is extremely crucial to reduce the risk of sight loss. Quitting smoking plays an important role in decreasing blood pressure and blood sugar levels and thus controlling diabetes. Also, it is important to keep a tab on sugar intake and cholesterol in the body to prevent the risk of sight loss associated with diabetes.

What is diabetic retinopathy?
It becomes one of the primary causes of blindness or vision loss inpeople who are affected by diabetes. There are three main stages associated with this eye disease:
Background or Non-proliferative Diabetic Retinopathy (BDR/NPDR): An early stage of the disease, it is marked by mild damage in the retina’s blood vessels. It might include slight bulging in the eye (microaneurysm), leakage of blood into the retina (haemorrhages), or deposit of cholesterol, fat or fluid (exudates).
Maculopathy: Diabetic maculopathy refers to the damage of macula, which is the part of the eye responsible for central vision. It may involve thickening or swelling of the macula, making it difficult for a patient to see small prints or recognise faces.
Proliferative Diabetic Retinopathy (PDR):It is condition that causes blockage or closure of the blood vessels in the retina, thus, hampering the flow of blood. It leads to growth of new blood vessels in the eye and the process is called neovascularization. Usually week and abnormal, these new blood vessels fail to supply adequate amount of blood to the retina. These vessels may bleed and cause scar tissue in the eye. The retina may witness wrinkling or pulling due to the scarring.

How diabetic retinopathy can affect a person’s sight?
Diabetic retinopathy may lead to a number of eye diseases that pose danger to an individual’s vision, such as:
  • Glaucoma
  • Refractive errors or temporary blurring of vision
  • Cataract
Can diabetic retinopathy be treated?
Yes, diabetic retinopathy is treatable. Laser treatment at the right time can help a patient get rid of many sight-threatening problems associated with the disease. The idea behind the laser treatment is not to improve the vision but just to preserve the sight that has been affected by diabetes. A high intensity laser beam targets the leaking blood vessels precisely and seals the fluid. The eye surgeon may carry out an extensive laser treatment in case of growth of new blood vessels.

What is the complete process of the laser treatment for diabetic retinopathy?
A person withdiabetic retinopathy can undergo laser treatment in an outpatient clinic under the supervision of an experienced eye surgeon. The process starts with dilation of pupils. Special anaesthetic eye drops are added to the affected eye prior to the placement of a contact lens. Too bright, the laser beam may lead tosome discomfort. The patient might experience temporary sight reduction for a couple of hours post the treatment. The central vision might also get affected for a little while. A patient’s vision might also be troubled by small black spots for some time.Extensive pan retinal laser may also lead to loss of some peripheral vision. Consulting only an expert for laser treatment is, therefore, advisable.

What isfluorescein angiography?
This medical procedure involves injection of a fluorescent dyeinto the blood through a vein on the patient’s arm. Retina and choroid’s vasculature gets highlighted with the dye, making it easier to be photographed for diagnosis of retinopathy. This further assists the surgeon in evaluating the results and planning the laser treatment for the patient.

How is diabetic retinopathy controlled with medications?
Anti-VEGF (Vascular Endothelial Growth Factor) drugs, such asAvastin(Bevacizumab) and Lucentis help in managing the growth of new blood vessels and age-related macular degeneration.
Injected into the eye’svitreous cavity, IntravitrealAvastinhelps in:
  • Preventing macular oedema, retinal vein occlusion or other macular diseaseslike ARMD
  • Reducing the growth of new vessels
Points to Remember
  • Annual eye examinations are important in order to diagnose and treat diabetic retinopathy at the initial stages.
  • Laser treatment can prove effective in managing most sight-threatening problems caused by diabetes.
  • Risk of diabetes and sight loss can be reduced by keeping blood pressure, blood sugar and cholesterol levels in check.
  • Quitting smoking is highly recommended.
  • Eat healthy.
  • Exercise daily.
For more info, please go through the below mentioned websites-
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