There are around 54.8 million diabetics in the MENA region in 2019, according to IDF Diabetes Atlas. This condition is present in 12.8 per cent of the MENA population and almost half of the cases remain undetected. Out of these, almost 20-25 per cent suffer from some sort of visual impairment due to diabetes. Hence, there is a need for growing awareness for this health condition in the region.
According to Dr. Raeba Mathew, HOD, Specialist Ophthalmologist, Canadian Specialist Hospital, Dubai: “The main reasons diabetics suffer from visual impairment is poor management of the condition and failure to seek an eye check-up. For diabetic patients, an eye check-up is just as important as checking the blood sugar levels while the patients don’t seem to be aware of that”.
Causes and diagnosis
Diabetic retinopathy is a condition where high blood sugar levels damage the retina, the nerve layer lining the innermost part of the back of the eye. It can lead to vision impairment by leakage of the fluid into the central part of the retina, causing a gradual loss of central vision. It can also lead to a sudden loss of vision due to the bleeding into the cavity of the eyeball, caused by rupture of small new blood vessels that grow in the retina because of diabetes where the patient may notice floating dots or even total loss of vision.
The detection of retinopathy can be done by retinal examinations followed by digital fluorescein angiography and a retinal scan. “Eye check-ups are not the top priority for diabetic patients who end up confusing them for the routine eye check-ups with the optometrist. But in fact, they are entirely different from each other and are covered by most insurance companies,” added Dr. Mathew.
“Early diagnosis of the condition is essential in the treatment of diabetic retinopathy. The first retinal examination should be done at initial diagnosis of Diabetes mellitus and, thereafter, every year. Patients, who have been diagnosed with retinopathy, may need to be seen more frequently. The incidence and severity of diabetic retinopathy depend on the duration and level of control of diabetes. Patients diagnosed with diabetes before the age of 30 years may have a higher chance of developing retinopathy,” added Dr. Mathew.
Treatment
Once detected, the treatment of diabetic retinopathy is first and foremost by informing, educating and promoting better diabetes management in the patient, regularising follow-ups with the doctor and monitoring the other aspects of diabetes including heart and kidneys. All stages of diabetic retinopathy do not require treatment for the eye. Depending on the severity of the retinopathy, the treatments available may be laser, injections or surgery.
“Diabetic patients need to have proper management of other risk factors such as high blood pressure, high cholesterol levels, obesity and anaemia. Smoking is to be avoided as it may further compromise the blood supply to all parts of the body, including the eyes. Mandatory eye check-up for retinopathy is needed at diagnosis and, thereafter, once a year or more frequently depending on the presence and severity of diabetic retinopathy.
“Early detection and timely treatment significantly help in preventing permanent impairment of vision due to diabetes. Regular eye screening is advised thereafter to monitor the effectiveness of treatment and also for further progression of retinopathy. As diabetes is a lifelong condition, retinal evaluation on a regular basis is mandatory along with control of blood sugar. Treatment instituted after the development of advanced diabetic eye disease, when visual symptoms occur, may not help much in restoring vision to functional levels,” concluded Dr. Mathew.