Diabetic Retinopathy

In the early stages of Diabetic Retinopathy, you might not be any symptoms or only mild vision problems.

However, as the condition progresses, you might develop:

• Spots or dark strings floating in your vision (floaters)
• Blurred vision
• Fluctuating vision
• Dark or empty areas in your vision
• Vision loss

Diabetes is a condition in which the body cannot cope with sugar and other carbohydrates due to a lack of insulin or because of an abnormal resistance to it.

Diabetes can cause complications, which affect different parts of the body including the eye.

1. Laser treatment
Laser treatment to the points of leakage for diabetic maculopathy can decrease the swelling and stabilise vision. More extensive laser treatment in the early stages of proliferative retinopathy can cause the abnormal blood vessels to regress, preventing more severe complications. However laser treatment is not without side effects. Some patients may experience a decrease in side vision (peripheral vision). Night and colour vision may also be affected.

2. Surgery
In some diabetic patients the disease progresses despite laser treatment, leading to persistent bleeding in the eye or retinal detachment. Vision then continues to deteriorate. In such severe cases, surgery such as a vitrectomy may be required.

3. Injection of medication inside the eye Injecting some medication e.g. Anti-VEGF – Ranibizumab (Lucentis®), Aflibercept (Eylea®), Bevacizumab (Avastin®), or steroids – Ozurdex®, Triamcinolone inside the eye may help to maintain or improve vision in some patients with diabetic maculopathy and can prevent progression of retinopathy in select cases.

Apart from the above mentioned treatment options for diabetic retinopathy and maculopathy, the most important aspect would be a multidisciplinary approach to control blood sugar, levels, blood pressure and blood cholesterol levels and screen for diabetes related diseases of other organs like the peripheral nerves and kidney.

Patients with diabetic retinopathy have to maintain regular check ups with their primary care physician and will need to attend specialist clinics for the eye, kidney and feet, as and when they are referred. Strict control of blood sugar, blood pressure and cholesterol with regular exercise will form the mainstay of treatment in addition to treatment of eye related disease.

It is important for patients diagnosed with diabetes to have eye screenings early in order to detect diabetic retinopathy. If diabetic retinopathy is not detected or treatment is not needed after the initial examination, it is equally important that diabetic patients follow up regularly with their eye screening as diabetic retinopathy may appear or progress with time.

Early treatment gives patients a good chance of maintaining vision throughout life. Without treatment, the risk of blindness is high.