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Diabetes and the Eye

Dr Mallika Goyal

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Management of Diabetic Retinopathy
Treatment depends on the stage of the eye disease, and includes one or more of the following:
I. Retinal laser
II. Injections of newer drugs, namely, Avastin, Lucentis or Macugen
III. Vitreous surgery

 

Macular Edema
This is the condition when central retina becomes thickened from fluid logging, and lipid deposition and vision becomes blurred.
Fundus Fluorescein Angiography is often required to study the retinal vessels and take a decision regarding treatment. A dye is injected in a vein in the arm, and retinal pictures are taken. 

 

Retinal Laser or Pan Retinal Photocoagulation
Laser is used to coagulate the peripheral and mid-peripheral retina which is not important for practical vision. This reduces the overall oxygen demand of the retina, and helps arrest the proliferative process, saving the useful central retina.

Laser should not be delayed if the eye has reached proliferative stage with high-risk characteristics. Focal laser treatment is considered for macular edema that affects clarity of vision or threatens the center of the macula.

End-stage Diabetic Retinopathy with Extensive Retinal Detachment: Laser alone is inadequate at this stage, and additional vitreous surgery is indicated.

 

Glaucoma in Diabetes
Diabetes is more commonly associated with glaucoma, a condition with high eye pressure and optic nerve damage.
Blindness can be prevented if eye pressure and optic nerve are checked periodically.

 

Prevention of Vision Loss in Diabetes

  1. Annual dilated-pupil examination is necessary in all patients with diabetes.
  2. Early detection of eye disease and appropriate treatment is the best way to maintain good vision.
  3. Annual dilated-pupil fundus examination is desirable beginning at the time of diagnosis of diabetes, especially so, because this disease continues to progress silently without causing any symptoms till it is in its advanced stages.
Dr Mallika Goyal, Consultant Ophthalmologist, Apollo Hospitals, Hyderabad
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