Di­a­betes and retinopa­thy

Jamaica Gleaner - - DIABETES WEEK FEATURE - Grad­u­ally it causes vis­ual im­pair­ment by one or more of the fol­low­ing causes: De­tach­ment of retina: Di­a­betic retinopa­thy is clas­si­fied in: DR ROBERTO MARTINEZ HERNÃNDEZ Di­a­betes As­so­ci­a­tion of Ja­maica

DI­A­BETES MEL­LI­TUS is a dis­ease that can be in­her­ited or ac­quired by bad eat­ing habits, seden­tary lifestyle, and a num­ber of fac­tors, both en­vi­ron­men­tal and cul­tural.

It is af­fect­ing more and more young peo­ple, re­mov­ing the ear­lier be­liefs that it was a dis­ease of old peo­ple.

Chronic el­e­va­tion of blood sugar lev­els is as­so­ci­ated with dam­age to small and large blood ves­sels. In the eyes such dam­age causes blind­ness (retinopa­thy), in the kid­ney, fail­ure (nephropa­thy) and it’s a cause of lower limb am­pu­ta­tion due to block­age lead­ing to gan­grene.

Di­a­betic retinopa­thy is the most com­mon cause of blind­ness in the West­ern world in the work­ing pop­u­la­tion. fifty per cent of di­a­bet­ics with over 10 years of knowl­edge of de­vel­op­ing the dis­ease have some de­gree of di­a­betic retinopa­thy; yet, it has no symp­toms in the early stages. Poor cir­cu­la­tion re­sult­ing in low blood oxy­gena­tion.

Mac­u­lar edema (is the most im­por­tant cause). It’s an in­flam­ma­tion of the vis­ual cen­tre in the retina.

Hae­m­or­rhages inside the eye (vit­re­ous in­traoc­u­lar haem­or­rhage).

Glau­coma, which is the in­crease of the oc­u­lar ten­sion by the oc­clu­sion of the drainage of the in­traoc­u­lar fluid (aque­ous hu­mor).

No di­a­betic retinopa­thy

Non­pro­lif­er­a­tive di­a­betic retinopa­thy. With four lev­els: Mild, mod­er­ate, se­vere and very se­vere.

Pro­lif­er­a­tive di­a­betic retinopa­thy. With three lev­els: No high-risk, high­risk, and advanced.

High blood pres­sure and high choles­terol ag­gra­vate the prob­lem.

Di­ag­no­sis is per­formed by ex­am­in­ing the oc­u­lar fun­dus with pupil­lary di­la­tion and re­quires the ap­pro­pri­ate fol­low-up by the oph­thal­mol­o­gist.

The most im­por­tant un­der­ly­ing treat­ment is to op­ti­mise the con­trol of blood pres­sure, blood glu­cose and choles­terol.

There are also treat­ment tools, such as laser treat­ment, surgery and ad­ju­vant med­i­ca­tions, and the choice of ther­apy depends on the type and stage of oc­u­lar com­pli­ca­tion. Pe­ri­odic fol­low-up by the oph­thal­mol­o­gist is a must.

For those per­sons with di­a­betes, at least half-yearly checks are rec­om­mended, and for those with­out any known dis­ease, a yearly check-up is wise.

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