Don’t Let Diabetes Blind You


Did you know that diabetes can affect your eyes? It can cause the loss of vision when it starts affecting your retina.

Ophthalmic surgeon Dr Keiki Mehta says that diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. “In the early stages, small fine blood clots develop on the retina accompanied with hazy white spots. At this stage, the retinopathy can be easily cured and reversed. In later stages, the vessels leak producing condition of macular oedema when the vision starts to get affected. As the vessels continue leaking, fibrous fine bands like cobwebs develop on the retina and as they heal, the fibrous bands pull off the retina causing retinal detachment at multiple places leading to total loss of vision.”

Consultant cataract and refractive surgeon Dr Nikhil Nasta says that the past two decades have seen an explosive increase in the incidence of diabetes in India, which has the largest number of diabetics in the world today. “This increased incidence of diabetes and its complications has been attributed to change in life style caused by increased urbanisation, high calorie diet, decreased physical activity and stress. Another cause for concern is that diabetes is striking at an early age among the urban population. Diabetics are also 25 times more likely to develop blindness, twice as likely to have a stroke, 2-4 times more likely to have myocardial infarction and much more likely to develop kidney disease or undergo amputation.”

Risk Factors

All people with diabetes are at risk — those with Type I diabetes (juvenile onset) and those with Type II diabetes (adult onset). During pregnancy, diabetic retinopathy may also be a problem for women with diabetes. It is recommended that all pregnant women with diabetes have dilated eye examinations each trimester to protect their vision.


Diabetic retinopathy often has no early warning signs. “In the early stages virtually no changes occur in vision. As the fluid gathers in the macular area, vision gets blurry. Sometimes the vessels leak a few drops of blood and the vision gets blurred only to recover again in few days. Any change in vision, even microscopic in a diabetic patient is a warning sign, which must be heeded,” says Dr Mehta.


Treatment involves sealing off the leaking blood vessels using laser. In the early stages usually that is all that is needed. Sometimes an injection is given in the eye called Lucentis or Avastin to stabilise the retina. In severe cases, Vitrectomy is done whereby the liquid at the back of the eye is removed.

“Early diabetic retinopathy usually has no symptoms. In early cases only regular follow-up may be necessary. More advanced cases require treatment to control the damage of diabetic retinopathy and improve sight. Laser photo-coagulation involves the focusing of a powerful beam of laser light on the damaged retina to seal leaking retinal blood vessels and stop abnormal blood vessel (neovascularisation) growth,” says Dr Nasta.

Early detection of diabetic retinopathy and timely laser treatment is the best protection against loss of vision. Diabetics must have their eyes examined regularly. The preventive measures are designed towards providing regular preventive care as well as follow-up for patients with established diabetic retinopathy. Additionally, all diabetics must maintain control of blood sugar and blood pressure and follow a regular exercise regime and healthy diet.

Juvenile diabetics must have their eyes examined at least once a year after the age of 12 years because diabetic retinopathy is rarely known to occur before puberty. Those with diabetes at an older age must have the eye examination done once at the time of diagnosis and then at least every six months to one year thereafter.

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