July 1, 2014
By Dr Nameeth D'Souza
Dr Nameeth D’Souza is a consultant vitreoretinal surgeon and founder of Mangalore Retina Care. He is a diabetic retinopathy specialist and specially trained in the treatment of all medical and surgical retinal diseases of the eye. He completed his MBBS and MS in ophthalmology under Rajiv Gandhi University of Health Sciences. He did a Medical Retina fellowship from Sankara Nethralaya Chennai and further went on to to do Fellowship in Vitreoretinal Surgery from the premier MM Joshi Eye Hospital in Hubli. With the increasing prevalence of retinal diseases in this region and patients having to travel to bigger cities for treatment, he started Mangalore Retina Care in 2012 with an aim to create awareness and provide quality retina care to people in and around Mangalore. Mangalore Retina Care is located at Falnir Clinic, Don Bosco Hall Cross Road, Falnir, Mangalore. He is also a visiting consultant at Vasan Eye Care, Mangalore.
Rakesh (name changed), a 46 year old businessman is a diabetic on treatment since 6 years. One fine day he suddenly noticed some black spots in front of his right eye. At that moment he ignored it, but slowly the black spots started increasing in number each day. On getting his eyes tested, he was found to have proliferative diabetic retinopathy, a stage which comes any time after diabetes sets in. He was treated with laser and after a few months of followup he was back on track.
Here is another instance, Suresh (name changed) was diagnosed to have hypertension and diabetes 15 years ago. His vision was low since a long time and despite the eye specialists advising him to undergo treatment he neglected it. He reached a stage where he could not see and had to depend on others even for his daily chores. The diabetic retinopathy had progressed to a stage wherein it was no longer possible to control by laser alone and surgery had to be performed.
Everyone isn’t as lucky as Rakesh and Suresh who got away with the disease. Some people turn irreversibly blind due to diabetic retinopathy.
As lifestyles and diet change, diabetic retinopathy is becoming an increasingly serious threat to eye health in India.
Normal eye
Diabetic retinopathy
Post laser treatment
The estimate of the actual number of diabetics in India is around 40 million (diabetes.co.uk) This means that India actually has the highest number of diabetics of any one country in the entire world.. Diabetes is also beginning to appear much earlier in life in India leading to chronic long-term complications in people.
It is estimated that there may be 11 – 20 million people with diabetic retinopathy by 2025. Diabetic retinopathy is one of the most frequent cause of blindness among adults aged 20-74 years.
Diabetes is a slow killer disease which does not spare any organ in the body. By the time the advanced diabetic retinopathy is detected, some damage to other organs, like the kidney has already begun.
All people with diabetes are at risk of getting diabetic retinopathy. This is true whether your diabetes is controlled by diet, tablets or insulin. You are at greater risk if:
You have had diabetes for a long time, Your diabetes is poorly controlled, You have high blood pressure, You are on insulin treatment, or You have associated kidney disease.
Looking after your diabetes can reduce the risk of you developing diabetic retinopathy and slow the rate at which it happens
The human retina is like the film in the camera, is very delicate and it is nourished by blood supplied in arteries and veins. The central part of the retina is called the macula which is responsible for the clear, central vision with which you are reading this article now.
Diabetic retinopathy does not usually cause a loss of sight until it has reached an advanced stage. However symptoms may include decrease in vision, blurring, seeing wavy lines, seeing spots etc.
There are various ways in which diabetic retinopathy can affect your eye:
The proliferative stage wherein new blood vessels are formed on top of the normal retina. These with course of time may bleed resulting in blood inside the eye (Vitreous Haemorrhage).
It can progress to a stage where membranes are formed on the retina and these can in turn pull the retina (tractional retinal detachment) or can create holes (Rhegmatogenous retinal detachment) or a combination of both (Combined retinal detachment)
There is a stage where fluid and lipids can collect in the most sensitive central part of the eye (Macular Edema)
Retinal lasers are a saviour when done at the right time. Laser needs to be given at the appropriate stage and ideally before your vision has been affected.
The proliferative stage of diabetic retinopathy can be treated with laser.
But the bleeding stage and the stage of retinal detachment will require surgery (vitrectomy)
The macular edema stage can be treated with laser alone or in combination with intravitreal injections into the eye.
However each treatment is tailored to the condition of the retina.
At least 90% of diabetic retinopathy can be averted if there is early diagnosis and proper treatment and monitoring.
All it takes is a 10 minute retinal examination to know if you have diabetic retinopathy. Why would you want it to progress to such a state where the reversal is almost impossible? And what is the use of having diabetes under control with no eye sight left?
A good healthy diet, exercise, a strict diabetic, hypertension and kidney care, cessation of smoking, a periodic physician’s evaluation along with retinal dilated examination are a few steps to ensure a healthy life.
You have only 2 precious eyes to see and enjoy the world. It is your responsibility to safeguard it!
Contact:
Dr Nameeth D'Souza
Mangalore Retina Care
Falnir Clinic, Don Bosco Hall Cross Road
Falnir, Mangalore - 575 001
Ph: 0824 - 2422166, 2422167
nameethdsouza@yahoo.com