Eye care in diabetics

What are the symptoms to watch for if you get diabetic eye complications?

If you have blurred or fluctuating vision, difficulty reading or seeing objects at a distance, dark spots or floaters in vision, flashing lights are usual symptoms. Eye pain, redness or pressure like symptoms need to be looked for. Sudden vision loss is a medical emergency

How often should the eye examination be done in all diabetics?

In type 2 Diabetes the commonest, first eye examination is done at the time of diagnosis then yearly once. In type 1 diabetics, the first eye examination is within 5 years of diagnosis then annually. In the case of pregnancy in diabetics, an eye examination before pregnancy or during the first three months of pregnancy is recommended.

Generally, how can the eyes be affected in diabetics?

Diabetic retinopathy is a common pathology. This is due to damage to the blood vessels in the retina. This is due to prolonged high blood sugar levels. Early stages are known as non-proliferative diabetic retinopathy. Late stages are known as proliferative diabetic retinopathy. The major cause of vision loss is diabetic macular oedema, this is due to the leakage of fluids in macular. Macular is a small central area in the retina. It is responsible for reading and recognising faces. Cataracts are formed early in diabetics at a younger age and progress more rapidly. Increased pressure in the eyes, temporary changes in the shape of the lens, and less production of tears causing dryness are common.

How to prevent eye problems in diabetics?

Maintaining a normal blood sugar at less than 7% HbA1C is recommended. Blood pressure management should be strict and a value of 130/85 maximum is ideal. Having normal cholesterol values with LDL values of less than 70 mg are recommended. Avoiding smoking completely is important. Smoking is deleterious for the heart and brain as well. Annual eye examinations for early detection of retinopathy and macular oedema are important.

Generally what are the treatment options ?

Laser photo coagulation to stop leaking blood vessels and prevent new blood vessel growth is a common treatment. Medications like anti-VEGF injections reduce swelling and prevent new blood vessel formation. Steroid injections are used in the eye to reduce diabetic macular oedema. Vitrectomy is the surgical removal of vitreous blood or scar in advanced stages

What are the complications of diabetic retinopathy?

This involves growth of abnormal blood vessels in the retina. Complications can lead to serious vision problems. Vitreous haemorrhage, retinal detachment, glaucoma and all these ultimately 8 leading to blindness or complete vision loss.

How is the diagnosis made?

Drops placed in your eyes will dilate your pupils to allow your doctor to have a proper look inside. In Fluorescein angiography a dye is injected peripherally in the vein, and pictures are taken as the dye circulates through your eyes blood vessels. The pictures can pinpoint whether your blood vessels in the retina are closed, broken or leaking,

What is Optical coherence tomography (OCT)?

This shows the thickness of the retina. This determines how much fluid has leaked in retinal tissue. Later OCT examination can be used to monitor how treatment is working.

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Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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