Di­a­betic retinopa­thy is a pre­ventable cause of blind­ness

Jamaica Gleaner - - DIABETES WEEK FEATURE - DR LIZETTE MOWATT Con­sul­tant Oph­thal­mol­o­gist (retina spe­cial­ist) Pres­i­dent Oph­thal­mo­log­i­cal So­ci­ety of Ja­maica

DI­A­BETES AF­FECTS very small blood ves­sels in the eyes. This af­fects the cir­cu­la­tion of the eye and poor cir­cu­la­tion can lead to vis­ual prob­lems. When di­a­betes af­fects the back layer of the eye (the retina) it is called di­a­betic retinopa­thy. This is a cause of poor vi­sion or blind­ness and is usu­ally due to poor sugar con­trol and is wors­ened if the pa­tient has hy­per­ten­sion or high choles­terol (high fat con­tent in the blood).

Di­a­betic retinopa­thy af­fects the eyes by caus­ing floaters (be­cause of bleed­ing in the eye) or blurred vi­sion from leakage of blood ves­sels in the cen­tral area of the retina (the mac­ula). Cataracts and glau­coma are more com­monly seen in di­a­betic pa­tients.

Di­a­betic retinopa­thy oc­curs due to un­con­trolled di­a­betes and is PRE­VENTABLE.

All Type 2 di­a­betic pa­tients (non-in­sulin de­pen­dent, usu­ally adults) must have a di­lated eye ex­am­i­na­tion at least once a year by an oph­thal­mol­o­gist (eye doc­tor) – a di­a­betic retinopa­thy screen­ing (DRS)

Type 1 di­a­betic pa­tients (in­sulin de­pen­dent, usu­ally chil­dren) must have DRS done by the fifth year of their di­ag­no­sis.

Pa­tients with early di­a­betic retinopa­thy are asymp­to­matic (no vis­ual com­plaints)

If left un­di­ag­nosed, it will lead to blind­ness. It is im­por­tant to de­tect it early.

Di­a­betic pa­tients are at risk of se­ri­ous vis­ual im­pair­ment if their eyes are not screened

Screen­ing with a di­lated eye ex­am­i­na­tion can pick up prob­lems in the eye (retina) early and treat­ment can be done BE­FORE vi­sion is lost.

Af­ter vi­sion is lost, it

may not be pos­si­ble to get it back again.

Treat­ment may in­volve laser treat­ment, spe­cial in­jec­tions or in very com­plex cases, reti­nal surgery. Good con­trol of the di­a­betes is es­sen­tial for the treat­ment to be ef­fec­tive.

Early treat­ment can save vi­sion. How­ever, in advanced dis­ease, surgery may only stop the prob­lem from get­ting worse (sta­bilise it) as the dis­ease has al­ready caused sig­nif­i­cant per­ma­nent dam­age to the eye­sight.

What can you do?

All newly di­ag­nosed di­a­betic pa­tients (Type 2/adult on­set) and those who have not had an eye ex­am­i­na­tion in the past year should be seen by an eye doc­tor for screen­ing. Af­ter the ini­tial screen­ing, you will need to be seen by your eye doc­tor, at least once a year for a di­lated eye ex­am­i­na­tion or sooner if prob­lems are found.

Di­a­betic retinopa­thy screen­ing, early di­ag­no­sis and treat­ment is es­sen­tial and can pre­vent vis­ual loss. If you are a di­a­betic, you must see your oph­thal­mol­o­gist at least once a year for a di­lated eye ex­am­i­na­tion, a glasses test alone is not ad­e­quate.

Good glu­cose con­trol is es­sen­tial to pre­vent di­a­betic retinopa­thy.

MEDICS are six check­list points to re­mem­ber to con­trol your di­a­betes.

MEDICS

1) Med­i­ca­tion: Be com­pli­ant with your med­i­ca­tions; take them daily and on time.

2) Ex­er­cise: At least 30 min­utes a day, three times a week – walk­ing, danc­ing, cy­cling, etc.

3) Diet: Watch your sugar (car­bo­hy­drate) in­take, eat lots of veg­eta­bles. 4) Avoid smok­ing. 5) Com­pli­ance: Reg­u­lar vis­its to your doc­tor and eye doc­tor.

6) Self-mon­i­tor­ing of blood glu­cose (must check your fast­ing and two hours af­ter a meal).

Dr Lizette Mowatt

Retina with di­a­betic changes (Di­a­betic retinopa­thy)

Nor­mal retina

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