What is diabetic retinopathy?
Diabetic retinopathy (DR) is a common vascular retinal disease affecting about 40% of type 1 diabetics and 20% of type 2 diabetics. Duration of the diabetes is the most important risk factor for DR.
Who are at risk for diabetic retinopathy?
All people with diabetes – both type 1 and type 2 – are at risk. That’s why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy.
Does diabetic retinopathy have any symptoms?
Diabetic retinopathy is symptomless in the early stages. By the time symptoms appear it become too late to stop the process of deterioration. The golden rule in diabetics is “Regular, frequent dilated eye examination.”
What are the types of diabetic retinopathy?
Non proliferative diabetic retinopathy is characterized by leakage of small blood vessels in the retina, which causes reduced vision. Proliferative retinopathy is characterized by the growth of new blood vessels on the surface of the retina, which may lead to vitreous haemorrhage and retina detachment.
How potentially blinding diabetes can be?
- Cataract often occurs at a younger age in diabetics.
- Decrease in vision due to Clinically Significant Macular Edema which affects the fine vision.
- Neo vascular Glaucoma can cause damage to the optic nerve and almost impossible to treat and control.
- At times diabetes can also cause weakness of the optic nerve or eye muscle.
- A diabetic patient is also more likely to develop sudden vision loss due to occlusion of the retinal vessels (branch or central retinal vein occlusion), vitreous haemorrhage, retinal detachment, or infections of the cornea and vitreous.
How is diabetic retinopathy detected?
Diabetic retinopathy is detected during a comprehensive eye exam that includes:
- Visual acuity test: This eye chart test measures how well you see at various distances.
- Dilated eye examination: Drops are placed in your eyes to dilate the pupils (Fundoscopy). The retina is examined for any signs of the disease.
- To confirm the diagnosis, to know the extent of damage, to plan treatment schedule, and to record various changes for future reference we may suggest an FFA and OCT.
How is diabetic retinopathy treated?
- The indications for treatment depend on the extent of severity of the disease.
- The various treatment options include Intravitreal VEGF inhibitors, Steroids, Laser Photocoagulation and Surgery.
What is a retinal detachment?
A retinal detachment is a separation of the neurosensory layer from the Retinal Pigment Epithelium. Most retinal detachments are a result of a retinal break either hole or tear.
What are the signs and symptoms of a retinal detachment?
- Flashing lights and floaters
- Shadow or curtain that affects any part of the vision
What are the risk factors for developing a retinal detachment?
- Younger adults (25 to 50 years of age) who have a high minus number (myopic)
- Associated with peripheral retinal degenerations
- Older people following cataract surgery.
What other factors are associated with a retinal detachment?
- Blunt trauma, as from a tennis ball or fist.
- Penetrating injury by a sharp object.
- A family history of a detached retina.
- In as many as 5% of patients with a non-traumatic retinal detachment of one eye, a detachment subsequently occurs in the other eye. Accordingly, the second eye of a patient with a retinal detachment must be examined thoroughly and followed closely, both by the patient and the ophthalmologist.
- Diabetes can lead to a type of retinal detachment that is caused by pulling on the retina (traction) alone, without a tear.
How to prevent Retinal detachment?
Retinal detachment can be prevented by doing a prophylactic barrage laser. Barrage laser is indicated in the following conditions
- One-eyed, Myopic, Aphakic
- History of RD in the fellow eye
- Symptomatic peripheral retinal degenerations
Why is it imperative to treat a retinal detachment?
A tear or hole of the retina that leads to a peripheral retinal detachment causes the loss of side (peripheral) vision. Almost all of these patients will progress to a full retinal detachment and loss of all vision if the problem is not repaired. Early diagnosis and repair are urgent since visual improvement is much greater when the retina is repaired before the macula or central area is detached.
Age-related macular degeneration
What is age-related macular degeneration?
Age-related macular degeneration (AMD) is a disease that affects the macula by an accumulation of metabolic bye products and thus blurs the sharp, central vision for activities such as reading, sewing, and driving.
Who is at risk for AMD?
- The greatest risk factor is old age.
- Smoking – Smoking may increase the risk of AMD
- Obesity – Research studies suggest a link between obesity and the progression of early and intermediate stage AMD to advanced AMD
- Race – Whites are much more likely to lose vision from AMD than African Americans.
- Family history – Those with immediate family members who have AMD are at a higher risk of developing the disease.
- Gender – Women appear to be at greater risk than men.
Tests for Age-Related Macular Degeneration
- Visual acuity test
- Dilated eye exam
- Amsler Grid Test