Introduction
Before beginning with diabetes and diabetic retinopathy & diabetic macular edema, you must know what is diabetes. Diabetes is the increased sugar level in the blood. When sugar rises in the blood above a certain level it may lead to various life threatening conditions and may lead to death of the person. It is the sweet killer and also known as silent killer of the life. Sugar is must for life but it may also worse your life. It can make you permanently blind. How just read it now.
Diabetes
Diabetes has become very common nowadays and you can find every 10th individual in your surroundings complaining about sugar ( diabetes ). It is very dangerous group of diseases. It never goes well. You can feel being well by taking medication for sometime. Diabetes actually an increased level of sugar in the blood. What actually happens, what we eat is converted into glucose after digestion. There is an organ located next to stomach which is Pancreas secretes Insulin ( anti- sugar or sugar controlling hormone ) that comes into the bloodstream.
Glucose or sugar is the strength of the cell and provides energy to the cell. As a result the cell is able to do work and performs various functions. Insulin is the key that opens the cell to get the glucose in. But when there is some issues in maintaining the sugar level, it leads to life threatening conditions.
Types of diabetes
1. Type-1 diabetes- In which the pancreas don’t able to make Insulin. Type-1 diabetes mostly affects infants and kids.
2. Type-2 diabetes- In which the insulin formed by the pancreas is not sufficient and can’t able to open the cell to get glucose in. Or we can say our body becomes unable to use the insulin. The body becomes resistant to insulin and on the contrary sugar level gets up in the blood. Type-2 diabetes mostly affects people above 25 years of age.
But how diabetes creates problem ?
Both types of diabetes increases the level of sugar in the blood due to which blood viscosity increases. Damage due to diabetes is seen first in organs- Eyes, Kidney, Liver and Nerves. It damages the blood vessels and make them leaky. Further the speed of blood flow in the body decreases due to high viscosity and as a result sometimes some organs don’t get the proper blood supply. So person can get sudden attack of angina, heart attack, stroke, paralysis, atherosclerosis etc. and may lead to death.
You must check your sugar level in every 6 months ( Fasting & PP ). So that you can take proper precautions before the condition worsen. Many people think that they don’t have diabetes and they spend lot of money over their expenses. But can’t spend little money for their sugar test as they complain why should they waste their money in sugar testing because they believe they don’t have higher sugar level. But they forget that diabetes is the silent killer that kills you slowly. You should check your sugar level in every 4-6 months period because your life is more than the money you have.
Besides the above conditions diabetes can make you permanently blind. Don’t take it lightly it can damage your retina. It causes a variety of eye diseases for ex – Diabetic retinopathy, Diabetes cataract, Diabetes macular edema, Diabetic glaucoma etc. If you get late in controlling your sugar level it may worsen the conditions
How human eye works ?
Before explaining what is diabetic retinopathy, you must know how our eye works. How we see the objects. Look human eye is like a camera. As a camera has lens and reel ( where photo is captured ) similarly our eye has a lens , cornea ( black part ) and light reaches to the behind portion of eye which is Retina. The retina converts the light into electrical signals and send it to the brain through a nerve ( optic nerve ) that connects retina to the brain. This is how we see the objects around us.
Diabetic Retinopathy
Diabetic retinopathy is very dangerous disease of retina of the eye. It is the damage of retina due to uncontrolled diabetes mellitus. Retina is the region in the eyes that lies behind your eyes. When light enters into the eye the retina converts it into electrical signals and send it to the brain through optic nerve. This is how we see the objects around us. People with any type of diabetes ( type-1, 2 ) have the highest chances of getting eye diseases. Diabetes is a life threatening condition that may cause your permanent vision loss.
You must have seen people complaining about they lost their vision due to diabetes. Although it is completely avoidable but people take it lightly. And don’t pay attention to it.
Symptoms of diabetic retinopathy
- Black spots / images moving in front of the eyes.
- Blurry vision
- Feeling something in the peripheral region
- Problems in looking at daytime
- Impaired color vision
- Vision loss
Types of diabetic retinopathy
1. Non- proliferative – It is symptoms less. In this the blood vessels become bulged and edema develops there. Some hard exudates left by blood accumulate there and cause leaky blood vessels. This is known as the first stage of diabetic retinopathy.
2. Proliferative – It is very advanced stage of diabetic retinopathy disease in which neovascular adhesion ( formation of new blood vessels ) occurs in the retinal region to supply the blood sufficiently. But these new vessels are very weak and cause leaky fluid in the vitreous humour ( liquid in the eyes ). Due to accumulation of some exudates below the retinal linings, may also lead to retinal detachment and loss of retinal cells ( due to hypoxia, deficiency of oxygen to cells ). Proliferative diabetic retinopathy makes a person permanently blind.
Therefore it becomes significant to do sugar testing in proper time of interval in order to get rid of such conditions. Get your check up by a diabetician along with a dietician. One will suggest medication for controlling your sugar and one will be giving you a perfect diet plan during medication. Repeat your follow up every 3-6 months. You will shocked to know if a person had diabetes in his life 10 years ago and if he/she completely fine now. Yet they get can some vision defects. So you need to be under comprehensive eye examination.
Causes of diabetic retinopathy
When sugar increases in your eye’s blood vessels, it damages the blood vessels and they start leaking. Hence the fats and fluids leaked from the vessels start deposited in the retinal region. Due to this retina gets swelling and cell loss. Increased sugar also blocks the blood vessels that leads to hypoxia. Hence oxygen doesn’t reach to eyes and brain send signals to produce VEGF ( Vascular endothelial growth factor ) for formation of new blood vessels ( neovascular vessels ). You will be thinking that new blood formation is good, but it is not so. These vessels are very weak and fragile so they burst and drain blood into vitreous fluid. Sometimes these vessels undergo constriction because of work load due to this they also constrict retina ( retinal detachment ) complete blindness.
Tests to detect diabetic retinopathy
- Pupil dilation – In this test the doctor put soke drops in the eyes to dilate the pupil and 10-15 minutes then check the retina using a opthalmoscope.
- OCT ( Optical coherence tomography ) – It is like CT Scan of eye in which pictures are taken using light waves and all layers of retina can been seen in this test along with leaky blood vessels.
- Eye angiography ( fluorescein angiography ) – The test in which a dye is injected in your blood vessels and then take pictures to study the blood vessels in detail.
- Tonometry – In this test the doctor check the intraocular pressure of the eye for corresponding future references.
Treatment of diabetic retinopathy
Controlling of diabetes plays a major role in treatment of diabetic retinopathy, no matter which treatment is given by the doctor. The treatment includes:
- Maintaining blood sugar level. More the control over blood sugar level lesser the defect in the retina.
- Anti VEGF injection like Avastin, Lucentis, Eylea etc. These decrease edema and neovascular vessels.
- Steroid injections to decrease swelling of Macula.
- Laser surgery to regress the neovascular vessels and edema in severe case and very high level of sugar.
- If more severe stage is found in which the retina has completely detached from it’s region. And vitreous humour has filled with blood. Then a doctor goes with Vitrectomy. In this the doctor replace vitreous fluid with another solution to save the vision.
Conclusion
So the diabetes is the lifestyle related disease. Smoking, eating high fatty food, having unhealthy lifestyle, not doing exercises, eating more red meat and high sugar content food you may get diabetes. If you have diabetes it should control in early stage and have good diet and maintain a healthy lifestyle. If diabetes affects the eye it called the diabetic retinopathy. Diabetes may affect lens also but diabetic retinopathy is most common among people. You should consult a doctor soon once you get symptoms of diabetes so that you can enjoy and see beautiful world around you.
Useful links
More about diabetic retinopathy
