Diabetes mellitus is a common metabolic problem in which the blood sugar is abnormally elevated. It results in progressive damage to the inner lining of the blood vessels throughout the body. Diabetic retinal damage is the 3rd most common cause of blindness worldwide.
DIABETES AND THE EYE
Diabetes causes multiple eye problems. Cataract formation and retinal disease are the most significant and are the focus of treatment for most patients with eye problems. Diabetic patients are also more prone to eye infections, blocked blood vessels on the retina and high pressure in the eyes – amongst other things.
Blood vessel problems are the hallmark of diabetes. The retinal blood vessels are particularly sensitive to abnormal blood sugar levels over a long period. The vessels leak and bleed on the retina and in the worst instances this results retinal detachment and blindness. When the blood vessels become involved we refer to the problem as diabetic retinopathy and this retinopathy ranges from mild in the early stages to very severe and sight threatening later on. In proliferative retinopathy abnormal blood vessels grow on the retina. These vessels leak and bleed and can cause blindness.
All diabetics should have routine eye screening, in particular for retinopathy and cataracts. The longer one has diabetes the more likely there will be eye involvement. In the early stages of eye disease there may be no symptoms and therefore routine screening is essential to identify problems before they become serious and irreversible.
The most important measures for eye health in diabetes is immaculate control of the blood sugar and blood pressure. Patients with excellent metabolic control tend to respond well to treatment while those with poor control often get severe eye problems.
Treatment of diabetic retinopathy varies from patient to patient. In the early stages we tend to observe and not to treat. Simply controlling the sugar levels and blood pressure can reverse mild retinal problems. In the later phases we have to intervene with treatments to avoid blindness and improve sight.
- Laser treatment – we use Argon laser to control moderate to severe diabetic retinal changes and this measure has been shown to dramatically reduce loss of vision if it is administered at the correct time and not too late in the course of the disease process. Laser is done in the consulting rooms and does not require admission or an anaesthetic.
- Avastin injections – painless injections of an anti-blood vessel growth agent has been shown to be of great value in controlling retinal disease. These injections are given under strict sterile conditions in the consulting rooms.