NEED OF SPECIALIZED EYE CARE FOR DIABETICS
Latest Pattern Scan Laser PASCAL & Anti-VEGF treatment.
Diabetes Mellitus (Sugar disease) is a common community health problem.
From an estimated 30 million patients in India alone. the figure is expected to increase up to 60 million cases by the year 2010. About 20% of all adults diagnosed to be diabetic for the first time are found to have already started developing complications in the eye. The diabetic patient is mostly unaware of the complications developing inside the eye till suddenly he/she notices a marked loss of vision. Sight threatening complications occur in a large number of diabetics and these if not diagnosed and treated in time can lead to permanent blindness. Diabetes can affect the eyes in many ways :-
- Increased risk of Cataract (Safed Motia): 2 to 4 times greater chances
than normal people.
- More chances of developing Glaucoma (Kala Motia).
- Frequent change in the number of glasses.
- Higher risk of eye infections like Corneal Ulcers or following any
eye surgery.
- Diabetic Retinopathy: This is one of the most serious eye complications of diabetes. It causes swelling and bleeding in the Retina (Parda) of the eye along with growth of abnormal new blood vessels which cause more complications. The damage is frequently permanent and hence needs prompt treatment. About one-fifth of all adults found to diabetic for the first time have already developed this complication. By twenty years of the disease nearly 100% of patients with Type I diabetes (childhood onset type) and 60% of Type II diabetes (adult onset type) have developed this complication.
Treatment of Diabetic Retinopathy
There is no effective medical (drug) treatment of this complication. A strict control of blood sugar level along with strict control of lipid profile and B.P. however is beneficial. All diabetic patients should have regular eye tests (every 6 months / yearly) by a retina specialist even if they do not feel any eye problem of their own. Those who have developed diabetic retinopathy may need more frequent check-ups. The only effective treatment is LASER photocoagulation. This is undertaken after the test of Fundus Fluorescein Angiography (F.F.A.) in which a fluorescent dye is injected into the vein of the arm and rapid photographs of the blood circulating inside the retina (parda) of the eye are taken. Laser machines emit a special type of laser light beam (infrared or green) which helps to coagulate or seal any bleeding or leaking blood vessels in the retina. Laser treatment (photocoagulation) is beneficial in minimizing further visual loss. New laser machines (PASCAL LASER) have made retinal laser treatment painless, faster and more precise. As and when diabetic retinopathy progresses. further sessions of laser photocoagulation may be required. If the bleeding inside the eye is too extensive for direct laser treatment and the same does not clear off on its own within a few months. the blood and fluid inside the eye have to be removed by the major operation of vitrectomy and endolaser. Laser treatment does not guarantee that diabetic retinopathy can be cured, it can only try to minimize the complications and save at least some useful vision in patients who if left untreated are at a very high risk of going blind. Certain new medicines (Anti-VEGF) like Avastin, Macugen & Lucentis are at times used to control leaking blood vessels (neovascularisation) and swelling inside the eye (macular edema). These are given as injections directly inside the eye with all aseptic precautions. People with tendency of brain stroke need special care.
Prevention of Diabetic RetinopathY
As explained abov, diabetic retinopathy can never be totally cured. So prevention plays a very important role. Though the duration of diabetes has a strong bearing on the occurrence of this complication (and this unfortunately increases with every year of having diabetes), a strict control of blood sugar, lipids & B.P. in consultation with the medical specialist is very important. Cigarette smoking, hypertension (high B.P.), and concurrent kidney disease increase the severity of the disease and thus should be taken care of. Thorough check-up by an eye specialist at the time of diagnosis of diabetes and at regular intervals subsequently aids in timely detection and prompt treatment of complications as and when they occur.
This information is for general guidance only, please ask your eye specialist, Ophthalmologist about specific advice in your case.
Issued in the interest of Public education & Eye care.
GROVER EYE & E.N.T. HOSPITAL, Estd. 1962. (Advanced Surgery & Laser centre) Equipped with the latest PASCAL LASER. Green. Infra-Red Diode Laser Photocoagulater, Endolaser. Vitrectomy machines and Fundus Camera for
Fluorescein Angiography (F.F.A.), colour and stereo Fundus photography.
140, Sector 3S-A, CHANDlGARH, Phones : 2660040, 2603323, 2666726, 2601203
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