Blinded by diabetes

Blindness. That is the curse of diabetes. No one knows it better than Dr Amod Gupta, head of the Opthalmology Department, PGI. His depart...

Blindness. That is the curse of diabetes. No one knows it better than Dr Amod Gupta, head of the Opthalmology Department, PGI. His department receives no less than 150 to 170 patients with diabetes-related vision defects every week. It is this flood of near-blind patients coupled with the widespread ignorance about the fallout of diabetes on the eyes, even among the medical fraternity, that is giving Dr Gupta sleepless nights.

8220;The eyes,8221; says the doctor, 8220;are one of the target organs of diabetes. Every diabetic must get his eyes examined regularly or he runs the risk of going blind.8221; The doctor speaks from a wealth of experience. The department was one of the first in the world to underline the need to monitor a diabetic8217;s eyes while treating him.

8220;There are three ways,8221; says Dr Gupta, 8220;in which diabetes affects the eyes.8221; It can cause macular oedema. In simple terms, it means the vessels surrounding the retina swell up and start leaking fat, blood, water, proteins, etc. These substances get collected in the eye and lead to blurry vision. 8220;Though this takes place after around 10 years of diabetes, the patient comes to us only when he8217;s unable to see clearly,8221; says Dr Gupta. 8220;At times, he discovers he is a diabetic only when he visits us!8221; he adds.

Diabetes can also result in stoppage of blood supply to certain areas of the retina, thereby rendering them dead or ischemic. Once this takes place in a significant part of the retina, some chemicals get liberated and trigger the growth of abnormal blood vessels. Unlike normal vessels, these bleed frequently. And once the blood floods the yellow spot, the area which enables us to see, the patient goes blind. 8220;It8217;s a sudden loss of vision,8221; says Dr Gupta. 8220;There is no warning. One minute, the patient can see, the next moment he is blind.8221; Diabetes can also lead to blindness by causing retinal detachment. In this, the retina gets detached due to the shrinking of scar tissue. In severe cases, the entire retina comes off. 8220;The only saving grace,8221; says Dr Gupta, 8220;is that these changes are gradual. They are also reversible, if detected early.8221;

A dilated eye exam helps an eye specialist gauge the damage done. 8220;We also undertake angiography to detect leaky vessels,8221; says Dr Gupta. These vessels are then plugged with laser rays, which also clear the debris accumulated in the eye. 8220;This helps retrieve vision in more than half the patients,8221; says Dr Gupta. For treating abnormal vessels, the dead parts of the retina are destroyed. This requires early detection. It takes us about six to eight weeks to clear the haemorrhage,8221; explains Dr Gupta. But if the blood doesn8217;t get absorbed, the doctors carry out Pars Plana Vitreous surgery. 8220;It8217;s a keyhole surgery. We introduce instruments into the eye through a .89-mm hole and remove the blood.8221; Laser photo coagulation is another process that keep abnormal vessels at bay.

A detached retina is re-attached by removing the scar tissue. 8220;All these procedures require immense expertise,8221; warns Dr Gupta, 8220;as there is no room for error.8221;

Dr Gupta asserts that 95 per cent of the patients can be cured in the PGI itself if they come in time. 8220;The problem is that few diabetics are told about the risk their eyes face as even doctors are not aware of it.8221;

Story continues below this ad

The key to better sight, says Dr Gupta, lies in controlling diabetes and getting the eyes examined by a retina specialist at least once a year. But he warns that the effect on the eyes can be only delayed, not eradicated. 8220;The eyesight of even those diabetics who got their pancreas transplanted, continued to worsen,8221; says Dr Gupta.

So, watch out if you are a diabetic.