He added that the presence of retinopathy is usually diagnosed in many patients only when they present vision loss. By this time, the disease would have become quite advanced. “The condition is caused when microvessels in the eyes are affected, resulting in the growth of new vessels that are called proliferative diabetic retinopathy. Many may not experience blindness even with significant retinopathy. Thus, creating awareness on the condition and its early diagnosis is important,” said Dr Mahesh G, consultant and HOD, vitreo retina, Giridhar Eye Institute, Kochi.
“Diabetic retinopathy is the most commonly seen retinal vascular disease. Retinal vein occlusion, radiation retinopathy, and hypertensive retinopathy are the other conditions,” said Dr Thomas.
Stay in control
The treatment depends on the stage at which the condition is diagnosed. “If diabetes and other metabolic factors are not controlled, it can worsen the condition. Other metabolic conditions, like hypertension, etc., should also be controlled. Here we need the help of other departments. The patients should be motivated to follow up and treat lifestyle diseases,” he said, adding that every diabetic patient should undergo vision screening and should be diagnosed at the earliest possible to prevent vision loss. “Many patients take proper treatment for some time. But as management becomes longer and longer, patients get tired emotionally and financially, and may drop treatment, making the condition worse,” said Dr Gopal.
When people skip treatment, it affects their livelihood too. “I have seen many people, especially drivers, struggling owing to the condition. When they are diagnosed with diabetes, they tend to avoid treatment and diet. However, when it affects the eyes, it leads to financial trouble for the entire family,” said Dr Thomas.
Treatment
Laser treatment is used when retinopathy goes into the next stage of initial bleeding or proliferative diabetic retinopathy. Its efficacy has been proven since the 1960s.
“It is used to avoid leakage of vessels and to prevent the formation of new vessels in the eyes. In the advanced stages, surgical treatment is opted to remove and correct blood vessels. Along with these options, diabetes control is important,” added Dr Mahesh.
“When the patient has high sugar levels, we may ask them to control sugar levels and visit again. They may try to solve the issue with the help of home remedies or some other treatment options, leading to a delay in treatment and making the outcome poorer,” said Dr Gopal.
“People tend to give eye treatment less priority even when the first eye is involved, as diabetics have many different problems. Once the second eye is involved, they will desperately seek treatment. By this time the first eye is already blind, and the second eye too is on the verge of blindness, making the person completely incapacitated,” he added.
The aim is early management with laser treatment to prevent vision loss, and as diabetic retinopathy progresses, there will still be visual symptoms, and patients take this as a failure of treatment and may drop the treatment. “It is a lifelong battle—with diabetes and retinopathy, consistency plays a significant role in treating and reversing the condition,” emphasised Dr Gopal.
