Diabetic Eyecare

How does diabetes affect the retina?

  • You should consult the doctor treating you for diabetes regularly and follow all instructions regarding diet and medication.
  • It is a fact that only strict control of blood sugar will help minimize damage to the retina. Frequent examination of the retina after full dilation of the pupil can help detect retinopathy early, leading to better treatment outcomes.
  • This retinal examination should be done periodically even if your vision is clear.

Can diabetes affect other parts of the eye?

  • Retinal changes are the major problem, but at times diabetes can also cause a rise in eye pressure (glaucoma), clouding of the lens (cataract), and weakness of the optic nerve or eye muscle.
  • Cataracts often occur at a younger age in diabetic patients. Glaucoma can cause damage to the optic nerve.
  • Diabetes is one of the several possible causes of glaucoma.
  • Damage to the small vessels of the optic nerve can affect vision, and weakness of the eye muscles may cause double vision.
  • A diabetic is also more likely to develop sudden vision loss due to occlusion of the retinal vessels (branch or central retinal vein occlusion), bleeding in the vitreous cavity, detachment of the retina, or infections of the cornea and vitreous.

How does diabetic retinal disease (diabetic retinopathy) affect the vision?

  • Swelling (edema) in the central part of the retina (macular edema) can cause blurring of fine vision.
  • Fragile new blood vessel sprouts may break and bleed into the interior of the eyeball, causing blurring of the entire field of vision.
  • In the early stages of the disease the vision remains good therefore, the disease may escape notice. That is why it is essential to have regular retinal examinations if you know that you have diabetes.

How can this disease be treated?

  • Swelling of the central part of the retina may be controlled with limited laser treatments. Sometimes one laser session will suffice, though some patients require several sessions. Abnormal blood vessel sprouts require extensive laser treatment involving 2,000 to 3,000 laser spots, i.e., three or more laser sessions.
  • Intravitreal Injections are also among the mainstays of Diabetic Retinal Management.
  • More acute problems with severe bleeding or retinal detachment require surgery such as scleral buckling or vitrectomy or both.

What are the results of the treatment?

  • Limited laser treatment in the central zone of the retina is designed to reduce the amount of future visual loss, but the lost vision cannot be restored.
  • Extensive laser treatment for fragile blood vessel sprouts usually prevents a large bleed within the eye, thereby preventing major loss of vision.
  • Vision loss from severe bleeding in the eye or retinal detachment can usually be improved with surgery, but some patients may not respond to the treatment.
  • Because we have as yet no cure for diabetes, it may continue to damage the retina even after laser treatment or even if the blood sugar level is controlled.
  • Patients with diabetic retinopathy need life-long regular follow-ups after treatment.

What are the complications of the treatment?

  • Most patients do not have any complications but occasionally, laser treatment may cause temporary pain or blurred vision since the effect of the treatment is seen only 4-6 weeks later.
  • Mild or severe hemorrhage or retinal detachment can also occur.
  • Such complications are occasionally seen after major eye operations and may very rarely lead to loss of complete vision.