What is Diabetes Eyes Awareness Month?
What is diabetes and how does it affect your eyes?
When there is an uncontrolled level of blood sugar, it results in damage to various organs of the body like heart, kidney, brain, and eyes. “Diabetic retinopathy” is the term used to describe damage to the very sensitive part of our eyes, the retina (back of the eye).
The kind of damage that takes place due to uncontrolled blood sugar levels is primarily the weakening of the small blood vessels, over time leads to blockage, and eventually leads to hemorrhages on the retina. This kind of damages is mostly irreversible, Which can lead to affect our vision to various degrees.
What is the Global and National magnitude of diabetes-related health issues?
International diabetes federation has projected that by 2040, 642 million people will have diabetes worldwide. According to the WHO, and there is no exact data of patients with diabetes in Nepal. However, the 2016 Diabetes Profile has shown that 9.1 percent of the Nepali population are living with diabetes.
It includes 10.5 percent men and 7.9 percent women. Diabetic retinopathy is the leading cause of blindness among individuals aged between 25 and 74 years worldwide. It affects three out of four individuals who have had diabetes after 15 years. More than one-third of the population with diabetes are found to have some form of diabetic retinopathy.
What are the types to diabetes-related damages to the eye?
Another mechanism of damage to the retina is again triggered by a decrease in oxygen supply due to damage to the blood vessels. In response to a decrease in oxygen, blood vessels multiply in number in an attempt to supply oxygen. However, these newly grown blood vessels are not strong enough for the job and they prematurely bleed into the retinal tissue, again resulting in loss of vision.
How aware are the patients (diabetics) about the need for regular eye check-ups?
Are there any ways of preventing diabetes-related damage to the eyes?
What are the treatment options available to those who have already had diabetes-related damage to their retina?
There are mainly two modes of treatment. The good thing about this treatment is that they work but not so good thing about them is that it might have to be ongoing for a long time.
- If there is swelling of the centre of the retina (macula), then the only treatment that might work is an injection of anti-VEGF agents (Inj. Avastin) into the eye. However, this mode of treatment is not straight forward. One might need several doses of this injection at monthly intervals depending on the extent of swelling. One dose of such injection costs around Nrs 7000. Hence, a massive financial burden to the family. Here, once again, I would like to stress on the fact that, if one has regular eye check-ups every 6 months, they might be saved from undergoing such intensive and costly treatment.
- In the case of new blood vessel proliferation, treatment of choice is laser treatment. In this, the laser beam is applied to the periphery of the retina in order to save the most sensitive central part of the macula. Again this treatment does not necessarily improve vision and is mainly to preserve remaining vision
- In many cases, there are mixed features of macular swelling as well as new blood vessel proliferation. In such cases, combination of treatment with laser as well as an injection into the eye is necessary.
How can we all work together to address this problem in the community?
The multi-disciplinary approach is what we need to control this problem. When I say the multidisciplinary approach, it means efforts from all the parties involved in the care of individuals with diabetes. The doctor, dietician, diabetes counsellor etc. should stress upon the importance of regular detail eye examination.
– Firstly, there should be guidelines and support from the government to implement nation-wide diabetic retinopathy screening program, which is still lacking.
– Secondly, these patients should be made aware of the eye-related complications that might arise in the future and how to prevent them.
– Thirdly, patients should also be proactive and listen to the advice given to them. They should keep in mind that management of diabetes is not just about blood sugar control but caring about their overall health including their eyes. Last but not the least, every eye hospitals should have a program to screen, monitor and manage diabetic-related eye diseases. It should be not only about treating the problem but about providing support and rehabilitation to those who have lost their vision due to diabetes-related eye complications as well.