Q. Can diabetes affect my eyes?

A. Yes. Just like diabetes affects the heart, kidneys, nerves, blood vessels etc, it can affect the eyes too. In fact, diabetes is a disease which causes imbalances in the entire body.

Q. How does diabetes damage my eyes?

A. The retina is the most frequently affected part of the eye in diabetes. This is known as Diabetic Retinopathy (DR). The blood vessels in the retina become leaky (microvascular leakage) and do not supply enough oxygen to the tissues (microvascular ischemia). As a result, the retina can develop swelling (Diabetic Macular Edema; DME) and start developing fragile new blood vessels which can cause bleeding (Vitreous Hemorrhage) in the eyes. Advanced stages of DR can have retinal detachment and painful blind eye. Besides DR, diabetes can also cause cataracts, corneal problems, optic nerve impairment etc.

Q. I am a diabetic since past few years but I have no vision problems, should I get my eyes checked?

A. Yes, Diabetes is a silent killer of the retinal tissues. Unfortunately, vision loss is nil to minimal in the early stages of diabetic retinopathy (DR). Vision problems begin only in the more advanced stages of DR and in diabetic macular edema (DME). 

Q. How frequently should I get my eyes checked?

A. Once-a-year eye check-up (with a trained retina specialist) is a must for all patients having diabetes. More frequent follow-ups are required if your eyes are found to have any stage of diabetic retinopathy.

Q. How long does it take to check for diabetic retinopathy?

A. A dilated eye examination is must to evaluate diabetic retinopathy. Dilatation with drops usually takes 15 to 30 minutes and the examination requires 5 to 10 minutes. Some special tests (OCT scanning, Fundus Photography, Fundus Fluorescein Angiography) may be advised for a more detailed workup. Vision may be blurred for a few hours due to dilating drops. 

Q. Is there a permanent cure for diabetic retinopathy?

A. Like for diabetes, there is no permanent cure for DR. But it can definitely be managed successfully to prevent loss of vision. Thus regular eye examination and timely treatment are necessary to prevent a decrease in vision.

Q. What are the treatment options for diabetic retinopathy?

A. The MOST IMPORTANT factor in the management of DR is a strict control of diabetes (i.e blood sugar, lipids, cholesterol, haemoglobin, kidney functions). Depending on the stage of DR, treatment can be in the form of laser, injections or surgery.

  • LASER: It uses concentrated rays of light energy. It is an office procedure (no admission or operations). It is done mainly for two purposes : 
  1. In cases of macular edema to seal leaky blood vessels. 
  2. To shrink fragile new blood vessels by treating the peripheral retina which reduces the chance of massive bleeding.
  • INJECTIONS: [AVASTIN, LUCENTIS, ACCENTRIX, RAZUMAB] These are specially designed antibodies to reduce levels of VEGF (Vascular endothelial growth factors) which is very useful to reduce macular edema and improve vision. More than one injection may be required as the effect lasts for 4 to 6 weeks. It is a painless procedure done in the sterile operation theatre.
  • SURGERY: This option is reserved for the more advanced stages of DR. MIVS (Micro Incision Vitreous Surgery) uses very minute incisions (0.4 to 0.6 mm) to perform complex eye procedures with better outcomes and minimal recovery time. After surgery, gas or silicone oil may be injected depending on retinal status.

Q. What precautions should I take to prevent vision loss due to diabetes?

  1. Strict control of blood sugars, lipids, cholesterol, BP, Kidney functions, anaemia. [Monitor long-term sugar control with HbA1c (</= 6.5%)]
  2. Regular moderate exercise (30 min brisk walk morning and evening)
  3. A healthy diet rich in vitamins, minerals and antioxidants
  4. Regular eye check-ups with a trained retina specialist
  5. Good compliance with treatment advice

With current knowledge, techniques and technology, vision loss due to diabetes can be successfully restored in an increasing number of patients. 

Prevention is still always better than cure and hence it is very important to have your eyes checked regularly (at least once a year) to preserve the precious gift of sight.