Diabetic retinopathy is an eye problem that can be caused by either type 1 or type 2 diabetes mellitus. Retinopathy occurs when diabetes damages the tiny blood vessels in the retina which may leak fluid and blood. It’s a sight threatening condition, however if diagnosed and treated, vision loss can be prevented.
Firstly, examination of the retina of the eye is done using indirect ophthalmoscopy after dilating the pupils. If diabetic retinopathy is found, specialized test.
- OCT (Optical coherence tomography).
- Fluorescein angiography (FFA).
These tests will help us in deciding the stage & treatment of Diabetic Retinopathy.
Laser Treatment : The aim of this treatment is to protect central vision. It does not restore lost vision, but it can prevent further deterioration, which is why early diabetic retinopathy diagnosis through periodic eye examination is imperative.
Intravitreal Injections (Anti VEGF agents) : Anti VEGF agents (Accentrix, Avastin, Eylea) are emerging as the new modality of treatment for various stages of diabetic retinopathy. These agents are injected into the eye (intravitreal injection). They are commonly used in diabetic maculopathy and proliferative diabetic retinopathy.
Surgery (VITRECTOMY) : A microsurgical procedure where the blood filled vitreous gel is replaced with a clear gas / solution / oil to restore vision.
Age - Related Macular Degeneration (ARMD)
Age - related macular degeneration (ARMD) is the most common cause of irreversible vision loss in people over age of 60 years. Cells in the macula degenerate (the central, and most sensitive part of the retina at the back of the eye) that is, they become damaged and die. Damage to the macula affects your central vision which is needed for reading, writing, driving, recognizing people's faces and doing other fine tasks.
Types of ARMD
ARMD is of two types
- Dry ARMD – (90%) : LESS SEVERE.
Vision loss is usually gradual. These patient's need to monitor their central vision regularly. If you notice any change in your vision, you should tell your eye doctor right away, as the dry form can change into the more damaging form which is wet (exudative) macular degeneration. While there is no medication or treatment for dry macular degeneration, some people may benefit from vitamin supplements (anti - oxidants).
- Wet AMD – (10%) : MORE SEVERE.
This can cause more damage to your central vision than the dry form. Wet macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina. This blood vessel growth is called choroidal neovascularization (CNV) because these vessels grow from the layer under the retina called the choroid. These new blood vessels may leak fluid or blood, blurring or distorting central vision. Vision loss from this form of macular degeneration may be faster and more noticeable than dry AMD.
- Blurred or distorted central vision.
- Colors look dim.
- Words on a page look blurred.
- Straight lines appear distorted.
- Dark or empty areas appear in the center of vision permanent loss of your central vision.
- Dilated retinal examination.
- Amsler Grid : To detect defects in central vision.
- Fundus Fluorescein Angiography(FFA).
There is NO TREATMENT for dry AMD, although high dose multivitamin combination has been shown to decrease the risk of visual loss.
There are a few treatment options for wet AMD although the best outcomes occur when this disease is detected early.
- Photodynamic therapy (PDT).
- Anti - VEGFs (Accentrix, Avastin, Eylea).
- Combinations of the above mentioned
Not all patient's may benefit from these, and treatment may not prevent further vision loss.
The retina is a nerve layer at the back of the eye that senses light and sends images to the brain.
Meaning of Retinal Detachment
The retina is the light - sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. If not promptly treated, retinal detachment can cause permanent vision loss.
- High Myopia (near - sightedness).
- Injury to the eye.
- Previous retinal detachment in the other eye.
- Family history of retinal detachment.
- Areas of thin / weak retina.
- Floaters which are little "cobwebs".
- Light flashes in the eye.
- Sudden blurry vision.
- An area of dark vision, like a curtain or a veil coming from above or below or from the sides. Floaters are a common symptom in otherwise normal individuals. However if these are accompanied by persistent flashes, they could be symptoms of a retinal tear or detachment.
Retinal tears without detachment - Laser photocoagulation or cryotherapy is performed around the tear to seal the retina to the back wall of the eye.
Retinal tears with retinal detachment - Requires surgery as soon as possible to put the retina back in its proper position. The longer the retina stays detached, the less the visual improvement after surgery. Scleral buckle surgery - A flexible silicone band is placed around the eye to counter the force pulling on the retina after removing the fluid under the detached retina.