What is Diabetic retinopathy? How can diabetes affect your vision?

With the advent of the 21st century, healthcare practitioners have witnessed a dramatic increase in the number of people being diagnosed with diabetes globally. According to the International Diabetes Federation (IDF), Diabetes affects an estimated 537 million adults worldwide between the age of 20 to 79 (10.5% of all adults in this age range).

By 2030, 643 million people will have diabetes globally, increasing to 783 million by 2045. India continues to have the highest burden of diabetes, second to only China. India is currently the 'diabetes capital of the world', as per a latest study by the Indian Council of Medical Research (ICMR) where the country now has over 101 million diabetics and a further 136 million pre-diabetic individuals.

Known as Diabetic Retinopathy, this complication is caused by damage to the blood vessels of the retina (the light-sensitive tissue at the back of your eye). In case of diabetics, the small retinal blood vessels become weak causing them to leak, swell or develop into branches. This deterioration leads to lack of oxygen supply and improper blood flow, leading to blurred vision. The condition affects with type 1 or type 2 diabetes and develops over time, especially if your blood sugar levels are not controlled. A recent study revealed that the prevalence of Diabetic retinopathy among persons with diabetes was 16.9%, the prevalence of sight-threatening diabetic retinopathy was 3.6%, and the prevalence of mild retinopathy was 11.8%.

Symptoms of Diabetic Retinopathy

In the early stages of the disease, you may not experience any symptoms. But as the condition progresses or worsens, one can experience cloudiness in vision and also might develop:

• Floaters (spots or dark strings floating in your vision)
• Dark or empty areas in your vision
• Blurred vision or fluctuating vision
• Even sudden vision loss

Diabetes patients are usually susceptible to developing a whole range eye disease such as Glaucoma, Cataract and Macular Edema, which typically occurs in conjunction with Diabetic Retinopathy. Since the condition involves the growth of abnormal blood vessels in your retina, it lead to serious vision problems. Other associated ophthalmic complications include bleeding into the central region of your eye (Vitreous Haemorrhage), retinal detachment and in some cases blindness.

How is Diabetic retinopathy diagnosed?

For diabetics, it is always a good idea to get your eyes tested frequently for diabetic retinopathy and other eye-related disorders. Every diabetic should get a yearly examination of the retina done to see whether there is any onset of retinopathy. Let us not wait till the vision drops down. Even if blood sugar levels are well under control and one does not have diabetes, there could still be retinopathy changes occurring in the eye. The condition can be diagnosed through a comprehensive dilated eye examination, where doctors will apply drops in your eyes to dilate your pupils, allowing them to examine the structures inside your eyes.

Treatment and prevention

The possible treatment options will depend largely on the type of diabetic retinopathy one has been diagnosed with and its associated severity. Usually, the treatment for this condition is aimed at slowing down the progression of the disease. Early detection and treatment can greatly improve the chances of keeping your sight intact. The treatment plan could include injecting medication into the eye to stop bleeding, photocoagulation, laser treatment, and vitrectomy, depending upon the severity of the condition.

When it comes to diabetic retinopathy, prevention is always the best option, especially since it cannot be cured, but only treated. There are several ways to prevent the onset of diabetic retinopathy, including:

• Controlling your blood glucose levels and blood pressure
• Keeping a check on your cholesterol and hypertension
• Cessation of smoking or the use of other forms of tobacco
• Visit your doctor regularly for any vision-related problems
• Reducing the amount of screen time and taking time-offs

Diabetes is a complex metabolic disease that puts individuals at risk for a whole host of associated complications such as cardiovascular disease, chronic kidney disease and even affects your eyes, including the retina, vitreous chamber, lens and the optic nerve. Hence, keeping diabetes in control along with visiting the ophthalmologist at regular intervals will help in slowing down the progress of Diabetes Retinopathy.

(Author: Dr. Sri Ganesh, Chairman and Managing Director, Nethradhama Super Speciality Eye Hospital, Bangalore)