Diabetic Retinopathy

What it is

Diabetes (diabetes mellitus) is a generalised illness with high blood sugar caused by the body being unable to properly breakdown, utilize and store food.

The high levels of sugar in the blood causes changes that affect different parts of the body including the heart, the kidneys, the nerves, and the eyes at the same time. The effect of the high sugar levels on the retina (the light sensitive membrane in the eye) is called diabetic retinopathy.

 

Who it affects

Diabetic retinopathy is a very important cause of blindness among diabetics. It occurs much earlier and is much more severe in diabetic patients whose blood sugar is not well controlled. It is a disease that usually affects the two eyes although it may be more severe in one.

 

What I should do

It is essential for a diabetic patient to control his/her blood sugar level. The benefits of good blood sugar control in a diabetic cannot be over emphasized. Diabetes is a life long illness with the potential for cumulative complications. Diabetics whose blood sugar is not well controlled are more likely to go blind and to die young than their counterparts who have good blood sugar control.

Regular health check-up with the endocrinologist (diabetes doctor) and the dietician are very important. They would advise the patient on what to eat, which drugs to use, and how to use them.

Regular eye check-up with the ophthalmologist is essential for sustaining good vision.

 

What the affected person notices

An individual who has diabetic retinopathy would notice deterioration in his/her vision. The deterioration may be gradual and progressive or sudden and profound depending on what is happening inside the patient’s eye.

Some of the changes that may cause deterioration in the vision of a diabetic are difficult to treat so it is important to detect them before they cause any damage. This underscores the importance of regular eye check-up.

Normal Vision


vision with diabetic retinopathy

 

What your doctor would do

The diabetic usually has two doctors directly involved in their care and each one has a different role to perform.

The diabetic doctor would perform a general examination and would request for some tests on a regular basis. The tests may include a fasting blood sugar and glycosylated haemoglobin estimation (these check the blood sugar control). He may also ask for a fasting lipid profile (to check the blood fat) and a serum electrolytes, urea, and creatinine (to check the function of the kidneys). He would adjust the patient’s medication based on the test results. He would also discuss the challenges of controlling the blood sugar and how to overcome them. He may also ask you to lose some weight and do regular exercise.

The ophthalmologist (eye doctor) would perform a detailed eye examination especially a dilated fundoscopy. He may request for some tests including fundus photographs, a fundus fluorescein angiogram, and an optical coherence tomogram. He may also request for B-scan ultrasonography.

What your eye doctor would do next would depend on the examination findings and the test results.

He may congratulate you on the excellent blood sugar control (if your blood sugar control has been good) and encourage you to keep it up. He may ask you to do retinal laser photocoagulation and/or have injections administered to your eye.

A session of retinal laser photocoagulation

In some cases, the eye doctor may ask you to have surgery done to improve the chances of maintaining good vision in your eyes.

 

What is the final result of treatment?

The treatment of diabetes is lifelong so there is no “final” result. However, with early detection, good blood sugar control and appropriate management of any complications, a diabetic is expected to have a long fruitful life. He/she is also expected to have good vision throughout his/her lifespan.