Detachments / Tears
Flashes and Floaters
Diabetic Retinopathy
Proliferative Retinopathy
Fundus Fluorescein Angiography
Macular Degeneration

Diabetic retinopathy is one of the leading causes of blindness among adults in the world. Approximately 25% of current diabetics have some form of the disease. The risk of developing diabetic retinopathy increases with the age of the diabetic person and the duration of the disease. It is estimated that 90% of diabetics may experience some form of diabetic retinopathy over the course of their life. However, only a small percentage of those developing diabetic retinopathy have serious vision problems, and even a smaller percentage become blind.

Diabetic retinopathy is a complication of diabetes mellitus which causes abnormalities in the tiny blood vessels nourishing the retina. These vessels weaken, leak fluid and blood, and fail to provide nutrients necessary for good health in the retina. Left untreated, diabetic retinopathy can result in severe visual loss, including blindness.

Though vision may gradually become blurred, significant loss of sight does not usually occur with background retinopathy. Since the patient does not experience pain or external symptoms such as bloodshot eyes or discharge, changes in the retina can go unnoticed unless detected by an eye examination.

A comprehensive eye examination is the best protection against the progression of diabetic retinopathy. The Sunetra Eye Centre can diagnose and treat diabetic retinopathy.

The innermost layer of the eye is composed of a delicate tissue called the retina which is comparable to the film within a camera. Visual impulses are received by specialized cells in the retina and transmitted to the brain via the Optic Nerve. The area which is responsible for enabling us to see clearly is called the Macula. Diabetic Retinopathy is the term applied to specific changes in the retina which can occur in people with diabetes mellitus. The incidence of diabetic retinopathy seems to be directly related to the duration of diabetes rather than to its severity or control.

The changes involve the small blood - vessels of the retina. The inner lining of these blood vessels are weakened and small outsourcings occur. These are termed Micro - aneurysms the blood vessels also become abnormally permeable and allow substances to leak freely into spaces where they should not normally enter. This results in water logging called oedema and deposition of material on the retina which is called Exudates. These changes will cause symptoms of blurred vision if situated at the macula. The more serious changes in diabetic retinopathy is the closure of the retinal capillaries.

This starves the retina of oxygen and stimulates the growth of abnormal blood vessels on the retina. These abnormal blood vessels are brittle and are a potential danger because they bleed easily. Such bleeding occurs either between the jelly within the eye (called the vitreous) and the retina or into the jelly itself. Such bleeds may clear spontaneously or may remain as such. Sometimes repeated bleeds occur and with passage of time leads to fibrous tissue formation which can contract and pull on the retina causing it to detach.

An eye with marked changes of diabetic retinopathy can have good vision and be totally symptomless. A reduction in vision occurs if the macula becomes water - logged, becomes involved in traction retinal detachment or if a vitreous hemorrhage locates itself in front of the macula. Seeing black spots, floating objects of various shapes and sizes and cob - webs are usually symptoms which point to a bleed inside the eye.

However, not all people with these symptoms have the changes within the eye that have been just described and only an examination of the retina by the eye doctor will help to clarify the situation . it may be gratifying to note that every diabetic need not have diabetic retinopathy.

Photocoagulation helps in preventing severe visual loss in eyes which run such a risk and vitreous surgery helps in restoring vision in eye where vision is severely affected by the disease process. Till today there is no medication either in the form of eye drops, oral tablets or injections that can prevent or cure diabetic retinopathy.

Patients who have diabetes mellitus but no diabetic retinopathy and those with minimal diabetic retinopathy do not need any treatment. They must however be carefully followed up periodically. However there are a group of patients who have very advanced disease where neither photocoagulation nor vitrectomy can help.

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