Lat month, we discussed about cataract in our weekly health column. We discussed what cataract is, causes and treatment where Dr. Patrick Mayan, the Ophthalmologist at the LifeCare Hospital Bungoma, took us through the details. The feedback we got were amazing and it only shows how these diseases are affecting so many people out there without knowing the solution.
Today, Dr. Mayang takes us through the continuation of eye problems with the topic of the day being diabetic retinopathy.
Diabetic retinopathy is damage to the retina caused by complications of diabetes mellitus. The condition can lead to blindness if left untreated.
Early blindness due to diabetic retinopathy is usually preventable with routine checks and effective management of the underlying diabetes, Dr. Mayn explains.
Fast facts on Diabetic Retinopathy
Diabetic Retinopathy is blood vessels damage in the retina that happens as a result of diabetes. It’s the leading cause of blindness in the United States.
Symptoms include blurred vision, difficultly seeing colours, floaters, and even total complete loss of vision.
People with diabetes should have their vision checked at least once annually to rule out DR. There are retinal surgeries that can relieve symptoms, but controlling diabetes and managing early symptoms are the most effective ways to prevent DR. DR is the leading cause of blindness in the United States. The retina is the membrane that covers the back of the eye. It’s highly sensitive to light. It converts any light that hits the eye into signals that can be interpreted by the brain. This process produces visual images, and it’s how sight functions in the human eye.
Diabetic Retinopathy damages the blood vessels within the retinal tissue, causing them to leak fluid and distort vision.
There are two types of DR.
- Non- Proliferative diabetic retinopathy (NPDR)
This is the milder form of diabetic retinopathy and is usually symptomless
- Proliferative diabetic retinopathy (PDR)
PDR is the most advanced stage of diabetic retinopathy and refers to the formation of new, abnormal blood vessels in the retina.
Worldwide one-third of the estimated 285 million people with diabetes show signs of DR.
Diabetic retinopathy typically presents no symptoms during the early stages. The condition is often at the advanced stage when symptoms become noticeable.
On occasion, the only detectable symptom is a sudden and complete loss of vision. Signs and symptoms of diabetic retinopathy may include.
- Blurred vision.
- The impairment of colour vision.
- Floaters, or transparent and colorless spots and dark strings that float in the patient’s field of vision.
- Patches or streaks that block the person’s vision.
- Poor night vision.
- Sudden and total loss of vision.
DR usually affects both eyes. It is important to make sure that the risk of vision loss is minimized. The only way people with diabetes can prevent DR is to attend every eye examination scheduled by their doctor.
Possible complications associated with Diabetic Retinopathy include:
1- Vitreous Hemorrhage
A newly formed blood vessels leaks into the vitreous gel that fills the eye, stopping light from reaching the retina. Symptoms include loss of vision and sensitivity to light, or floaters in milder cases. This complication can resolve itself if the retina remains undamaged.
2- Detached retina.
Scar tissue can pull the retina away from the back of the eye. This usually causes the appearance of floating spots in the individual’s field of vision, flashes of light, and severe vision loss.
A detached retina presents a significant risk of total vision loss if left untreated.
The normal flow of fluid in the eye may become blocked as new blood vessels form. The blockage causes a buildup of ocular pressure, or pressure in the eye, increasing the risk of optic nerve damage and vision loss.
Causes and risk factors
Anybody with diabetes is at risk of developing diabetic retinopathy. However, there’s a greater risk if the person
- – Does not correctly control blood sugar levels.
- – Experiences high blood pressure.
- – Has high cholesterol.
- – Is pregnant.
- – Smokes regularly.
- – Has had diabetes for long time.
Damage to the network of blood vessels that nourish the retina is key cause of diabetic retinopathy.
High glucose levels damage these vessels and restrict the flow of blood to the retina. The problems with the blood vessels can be as mild as tiny bulges in the vessels wall that occasionally leak blood without affecting vision.
However, in the advanced stages of the condition, these blood vessels may become completely blocked. The eye then produce new, less stable blood vessels.
The new vessels break easily and leak into the vitreous gel of the eye. The bleeding causes blurred and patchy vision by further blocking the retina.
This bleeding, on occasion, forms scars that can separate the retina and the eye, leading to a detached retina. As the symptoms develp, a person with DR becomes increasingly likely to experience complete vision loss.
Diabetic retinopathy generally starts without any noticeable change in vision. However, an Ophthalmologist, or eye specialist, can detect the signs. It’s crucial for people with diabetes to have an eye examination at least once or twice annually, or when recommended by a physician.
Treating DR depends on several factors, including the severity and type of DR, and how the person with DR has responded to previous treatment. With NPDR, a doctor may decide to monitor the person’s eye closely without intervening. This is known as watchful waiting. Individuals will need to work with their doctor to control diabetes. Good blood sugar control can significantly slow the development of DR. In most cases of PDR, the patient will require immediate surgical treatment. The following options are available:
2-Focal laser treatment, or Photocoagulation.
The procedure is carried in a doctor’s office or an eye clinic. Targeted laser burns seal the leaks from abnormal blood vessels. Photocoagulation can either stop or slow down leakage of blood and buildup of fluid in the eye.
3-Scatter laser treatment, or pan-retinal Photocoagulation
Scattered laser burns are applied to the areas of the retina away from the macula, normally over the course of two or three sessions. The macula is the area at the center of the retina in which vision is strongest.
This is the removal of the vitreous from within the eyeball. The surgeon replaces the clouded gel with a clear liquid or gas. The body will eventually absorb the gas or liquid. This will create new vitreous to replace the clouded gel that has been removed.
Any blood in the vitreous and scar tissue that maybe pulling on the retina is removed.
For the majority of people with diabetes, DR is an inevitable consequences. However, patients with diabetes who successfully manage their blood sugar levels will help to prevent the onset of a severe form of DR.
High blood pressure, or Hypersensitive is another contributing factor. Patients with diabetes need to control their blood pressure by
- – Eating a healthy and balanced diet.
- – Regularly exercising.
- – Maintaing a healthy body weight
- – Smoking cessation.
- – Strictly controlling alcohol intake.
- – Take any antihypertensive measures according to their doctor’s instructions.
- – Attending regular screening.
- Early detection of symptoms increases the effectiveness of the treatment.
All these services are available at LifeCare Hospital Bungoma and patients are allowed to pay using insurance cards if they do not have cash.