Diabetic retinopathy (DR) is the manifestation of diabetes mellitus (DM) in the retina which is the screen of the eye .
While it is true that India has a high prevalence of Infectious diseases, we also have a large burden of Diabetes! A recent study conducted by Indian Council of Medical research (ICMR) covering nearly 50% of the geographical area in India found that 7.3% of people above the age of 20 years are diabetic and another 10.3% are in a pre diabetic state. Simply stated, 1 in every 5 adults either has diabetes or are at a risk of having diabetes. So yes, we need to worry about diabetes in India!
Every person with diabetes needs to be evaluated for diabetic retinopathy. Some guidelines say that the changes of DR start after 5years of onset of DM. However, since one may not always know the exact period when DM has started, it would be ideal to get oneself evaluated at the earliest.
Presence of poorly controlled DM for a long period is the main risk factor. Other factors include Hypertension (High BP), Anaemia,Abnormal cholesterol levels, Smoking and associated heart or kidney ailments.Pregnancy can also aggravate DR.
Evaluation for DR involves dilatation of the pupils of the eye followed by a fundus examination. Incidentally, the retinal blood vessels are the only internal blood vessels of the human body which can be directly visualised by human eye using proper instruments.
A person usually experiences a vision related problem when the central part of the retina called as macula is either obscured or involved.The disease might be active in other areas of the retina without causing any symptoms. Hence, the absence of symptoms need not necessarily mean that the disease does not exist. Therefore evaluation is a must for every person who is a diabetic.
In the early stages of the disease or when the central part of the retina is not involved, the doctor usually advises good control of systemic conditions like diabetes, hypertension, cholesterol , kidney functioning and haemoglobin levels. Smokers are advised to gradually quit smoking as it is known to accelerate the disease inside the eye. In the late stages of the disease the doctor might advise tests based on the condition inside the eye as well as systemic conditions like hypertension and renal function. Decisions regarding management which could be LASER, injections or surgery would be based on the nature and severity of the problem.
DR is a manifestation of various systemic conditions of the body in the eye. Keeping them in good condition helps improve the patient’s quality of life. A simple acronym TRACK sums up the measures needed to be taken
T –Take your medicines regularly.
R- Reach and maintain a healthy body weight.
A-Add more physical activity to your routine
C- Maintain your ABC, where A stands A1c (HbA1c which measures our body's average sugar level in the past 3 months, B stands for blood pressure and C stands for Cholesterol
K-Kick the smoking habit
The prognosis is usually linked to how early the condition is detected and what is the status of the associated risk factors. It is a perfect example of the adage “A stitch in time saves nine.” The earlier a patient presents and the better is his/he control of diabetes and other risk factors, the better is the outcome.
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