Diabetic Retinopathy

Diabetes is a disease affecting the blood vessels in the body. When high blood sugar levels damage blood vessels in the retina, it is referred to as diabetic retinopathy. Retinopathy affects the vision. However, keeping diabetes under control and getting eyes checked regularly and treated can stop or reduce further damage to the vessels.

Non Proliferative Diabetic Retinopathy(NPDR) 

When the vessels leak blood or fluid it causes the retina to swell or to form deposits called Exudates. When only the peripheral area of the retina is affected the vision is not affected. However, when the effect is on the central area, like macula, the vision is affected.    Such people may experience blurred or distorted vision or dark spots may appear in the field of vision. When one eye is affected the other is also most likely to be affected. In worst cases the vessels in the macula are blocked and macula stops functioning due to less supply of blood. This is the primary reason of blindness. The damage can be reduced by controlling diabetes and treating by laser, if required.  However, the damage that is done is irreversible.
 
Proliferative Diabetic Retinopathy(PDR)

In such cases there is widespread     closure of retinal blood vessels, preventing   oxygen reaching the retina. The retina           responds by growing new blood vessels (abnormal new vessels). Blood and fluid leak more from such vessels. In some cases blood is leaked into the eye increasing the chances of detachment of retina. PDR may cause more severe vision loss than NPDR. 
Diabetes must strictly be kept under control Early detection of diabetic retinopathy is the best prevention Those with diabetes must get their eyes checked every year so that the doctor can diagnose as soon as retinopathy sets in. The doctor can start treatment even before a patient has symptoms. Those diagnosed with retinopathy should get their eyes checked every 3 to 6 months.
 
Treatment of Diabetic Retinopathy 
  • Laser: Many patients require to undergo more than once. 
  • Injection in the eye: It is given to shrink the newly created blood vessels.
  • Surgery: It is suggested to those who have blood clots in the eye. In some cases surgery is recommended in case of retinal detachment.
 
Retinal Detachment

Retina is a layer made of nerves at the back of an eye. It captures images of objects. When the retina is pulled away from its position then it can not capture images resulting in blurred vision. This is a serious condition as a person may lose sight if left untreated.
The hollow in the middle of the eye is filled with a clear gel called ‘vitreous.’ As we grow older, the vitreous may pull away from its attachment to the retina. Sometimes such pull may be hard enough to tear the retina. Fluid may pass through the   retinal tear(hole) lifting the retina off the back of the eye. This condition is known as retinal detachment.

Conditions that increase the chance of having a retinal detachment
  • Nearsightedness (high minus numbers)
  • Previous cataract surgery (higher chance in old method)
  • Glaucoma
  • Severe injury to the eye
  • Previous retinal detachment  
  • Family history of retina detachment
  • Weak areas in retina (seen by doctor)
Preventing retinal detachment: If there is only tear and no detachment then it is treated by laser or Cryotherapy. Those with above  mentioned conditions must get the retina checked regularly.

Treatment: If the retina is detached then it can only be fixed by surgery. Surgery is        successful in most cases. However, sometimes more surgeries may be needed. Even after the surgery it may take months to get good vision. In some cases there may be partial gain where as in some cases there may not be any gain of vision. After fixing the retina it resumes it works but no one can know and tell how much vision will be restored.

Macular Degeneration 

Macula is a tiny but important area of retina. It identifies the objects in area of central vision of an eye. The other area of retina identifies objects  in area of peripheral vision of the eye. Hence, macula allows one to see fine details clearly. When the macula does not function correctly, the central vision is affected by blurriness, dark areas or distortion. As a result some activities, like threading a needle or reading, difficult or impossible. However, as the peripheral vision, usually, is not affected, even in more advanced cases, people continue to have some useful vision and are often able to take care of themselves. Most cases of macular degeneration are as part of the body’s natural aging process. Macular degeneration causes different symptoms in different people. The condition is hardly noticeable in its early stage. Sometimes, only one eye loses vision while the other eye continues to see well for many years.

Administrating injection in the eye or treating with laser may be required in some cases. In some cases combination of both may be used. In some advanced cases devices like magnifying glasses are required to be used.