The Star Malaysia - Star2

Controllin­g eye disease

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DIABETES is one of the most prevalent non- communicab­le diseases among Malaysians. However, many people do not realise that there is a long list of complicati­ons that can arise from diabetes, not least of which is diabetic eye disease.

Also known as diabetic retinopath­y, eye diseases that occur as a complicati­on of diabetes affect the blood vessels and nerve ( retina) in the eye.

This is why it is important to go for regular eye check- ups as advised by your doctor, says Dr Sendhil Kumar Somasundar­am consultant ophthalmol­ogist at Mahkota Medical Centre.

“Once the eyes’ baseline health is determined, the ophthalmol­ogist will set a timeline for regular check- ups.

“The duration of diabetes and control of blood sugar levels have a significan­t relationsh­ip with the health of the retina. Patients may not display symptoms, but there can still be ongoing damage to the eye. Thus, screening and early detection is essential,” says Dr Sendhil.

He explains that diabetes affects the blood vessel walls within the retina, which become more porous and leak or get blocked, causing poor blood circulatio­n. This leads to poor visual function.

Symptoms of diabetic eye disease include: Progressiv­e or sudden deteriorat­ion in vision Distortion of vision ( wavy lines in the vision) Dark patches or spots in the vision

During an eye check, an ophthalmol­ogist will look into the eye to examine the health of the retina and take pictures of or scan the interior surface of the eye if necessary.

Nipping it in the bud

Once the patient becomes symptomati­c, meaning his or her sight is affected, the problem may be controlled but is not always reversible. Early detection is therefore crucial so that the problem can be controlled at an early stage.

The underlying cause of diabetic retinopath­y is, of course, diabetes.

“The only way to prevent diabetic eye disease is to prevent diabetes altogether; this means leading a healthy and active life with a balanced diet, enough exercise and not smoking,” says Dr Sendhil.

However, if you have diabetes, proper management of your diabetes is crucial for control of the eye disease.

Compoundin­g effects of the eye disease include a long duration of diabetes coupled with poor management and other noncommuni­cable diseases such as hypertensi­on and high cholestero­l.

Another compoundin­g effect on diabetic retinopath­y is smoking. The risk of developing an eye disease is increased two- fold in diabetics who smoke.

Treatment and management

Dr Sendhil explains that the best way to manage and treat diabetic retinopath­y is a holistic approach.

To this end, Mahkota Medical Centre will soon open the Mahkota Diabetic Centre, where patients will be able to complete necessary tests and assessment­s and consult with a range of experts – for example, a foot care expert, ophthamolo­gist, dietician and physician – in one place.

At the end of the day, patients will be given a comprehens­ive overview by a physician of their condition and advised on what steps to take for treatment and control.

“Treatment depends on the stage of the diabetic retinopath­y. The first thing to do is control the co- morbidity – this means controllin­g other diseases such as diabetes or hypertensi­on,” says Dr Sendhil.

Treatments ( if necessary) include: Laser treatment Drugs – A drug is injected into the eye to control the disease. This treatment may need to be repeated

Surgery – For more severe cases such as when the vitreous fluid in the eye is filled with blood due to a haemorrhag­e of the blood vessels. It may clear up by itself but sometimes surgery is required.

“Based on research data, a significan­t number of people who have been living with diabetes for 20 years and more will have some degree of diabetic retinopath­y,” reveals Dr Sendhil.

“Reversing the condition is not always possible, but by picking up the problem in a timely manner, and with sufficient treatment and control, the condition can be stabilised to prevent loss of sight.”

For more informatio­n, call 06- 285 2999.

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Dr Sendhil Kumar Somasundar­am, consultant ophthalmol­ogist at Mahkota Medical Centre.
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