Keep a check on diabetes to avoid visual impairments. A special article by Vivek Singh Chauhan to mark World Diabetes Day
Diabetes, if not checked in time, may lead to serious eye problems that may even lead to blindness in later life, health experts have warned. High blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, which leads to diabetic retinopathy.
“Diabetes mellitus causes blindness by many mechanisms such as retinopathy, cataract formation (whitening of the lens of the eye), glaucoma (elevated eye pressure) and eye blood vessel blockage,” said Md. Ashraf Ganie, Associate Profesor, Endocrinology and Metabolism, AIIMS, New Delhi.
The serious eye problems caused by diabetes may show no symptoms or mild vision problems, but eventually it may cause blindness,” he added.
“People with a long duration of uncontrolled diabetes are prone to retinal damage, which may cause either PDR (Proliferative Diabetic Retinopathy), CSME (Clinically Significant Macular Edema — the build-up of fluid in the macula, the vision area at the centre of the retina) or Proliferative Vitreoretinopathy. It can further lead to retinal thickness, retinal detachment and blindness,” said Mihir Raut, Physician and Tutor Diabetology at Nanavati Super Speciality Hospital, Mumbai.
“Diabetic retinopathy includes swelling in the macula. It can affect either of the genders. Risk increases with increasing age, though it is more dependent on duration and control of diabetes,” said Ritesh Narula, Consultant, Retina and Uvea services, Centre for Sight.
Diabetic retinopathy is an ocular manifestation of diabetes, a systemic disease that affects up to 80 per cent of all patients who have had diabetes for 10 years or more.
Women who develop or have diabetes during pregnancy may also see the rapid onset of diabetic retinopathy.
According to experts, the condition of diabetic retinopathy can develop in anyone who has Type 1 or Type 2 diabetes, but mostly people with Type 1 diabetes are at the higher risk.
Initially there are no symptoms of early diabetic retinopathy. It may depend on the system and organ involved. Most of the diabetic patients are advised to have their eyes checked by an eye specialist on a regular basis.
“The symptoms come in an advanced stage of diabetic retinopathy when one starts experiencing blurring of vision which cannot be corrected by glasses or sudden loss of vision,” said Neeraj Sanduja, Senior Consultant, Opthalmology, Fortis Memorial Research Institute.
Apart from eye problems, uncontrolled diabetes can lead to heart problems, stroke, genitourinary problems, nerve damage, foot problems, skin diseases, sexual problems and depression.
Sometimes people with diabetes don’t realise that they have the disease until they begin to have other health problems like heart disease, eye complications, kidney disease, nerve damage, foot problems, skin complications, dental disease, erectile dysfunction and the like,” Mudit Sabharwal, Consultant Endocrinologist at Pushpawati Singhania Research Institute (PSRI) here, told IANS.
Laser treatment is usually very effective against diabetic retinopathy for preventing vision loss if it is done before the retina has been severely damaged. Surgical removal of the vitreous gel (vitrectomy) may also help in improving vision if the retina has not been severely damaged.
“Diabetic retinopathy can be treated with laser or injections in the eye. Advanced cases may need vitreoretina surgery,” Narula added.
Diabetic complications can be prevented by maintaining a good lifestyle, such as maintaining blood glucose values in the normal range by diet, exercise, medication, self-monitoring of blood glucose and yearly screening and a complete body check-up, including the eyes and heart.
“There is no satisfactory treatment for diabetic retinopathy. The key lies in prevention (by good glucose control) and early detection by annual fundoscopic examination by a qualified eye specialist,” Ganie added.