Myths and facts on diabetic retinopathy - Dr P Tandava Krishnan
by Shrutee K/DNS
Senior consultant, Vitreo retinal services
Maxivision superspeciality Eye hospital, Madhapur
Myth 1: We are a
developing country. Diabetes is primarily a problem of developed countries.
Fact: A recent study conducted by Indian council of
medical research (ICMR) has found that nearly one in every 5 Indian above the
age of 20 years is either a diabetic or at risk for diabetes. In fact India has
earned the dubious sobriquet of being “World’s diabetes capital”. So diabetes
is a big problem in India.
Myth 2: Diabetes
is predominantly a problem of urban areas
Fact: A study
conducted in South India has found that the prevalence of Diabetes is similar
in both urban and rural areas. So people in rural areas are also at risk of
developing diabetes and it’s complications.
Myth 3: My recent sugar levels are normal. Hence I am
safe from any possible complications of diabetes.
Fact:
Complications due to diabetes are a net effect of the number of years of
diabetes as well as the level of control of diabetes during the entire period
of having diabetes. People who have had strict control of diabetes from the
beginning have better outcomes as compared to those who have had poor control
for long duration and have started control of diabetes only in the near past.
Myth 4: My sugar
levels are largely under control. Hence I will not have any complications like
retinopathy (eyes), neuropathy (nerves) or nephropathy (kidney).
Fact:
Complications due to diabetes develop not only due to poor control of sugar
levels but also due to associated factors like poor BP control, Anaemia,
impaired lipid control ( abnormal cholesterol levels), smoking, kidney problems
and cardiovascular problems. So it is essential that all the associated factors
are also kept under control.
Myth 5: I got my glasses checked recently;
hence I don’t need further eye checkup.
Fact: Checking of
glass power (refraction) is just a small part of the total eye examination. Eye
examination includes aspects like checking for eye pressure, angles, cornea,
lens status, pupillary response and fundus examination. Many treatable
conditions of the eyes may not get their due attention unless a thorough
examination is done.
Myth 6: My vision
is fine. I have no other symptoms. I don’t think I need a dilated retinal
examination.
Fact: A person’s
vision is usually unaffected unless the central part of the retina called
macula is affected. To elaborate, there may be many changes inside the eye
(diabetic retinopathy) which may need urgent treatment without the patient’s
vision being affected. And the condition may be too advanced by the time
patient becomes symptomatic. Hence it is prudent for the patient to get a
thorough eye evaluation done once he/she knows that they have diabetes.
Myth 7: I have
had bleeding inside my eye, immediately after the doctor had treated my eyes
with LASER. I think he/she treated me shoddily and the bleeding is a direct
effect of the inefficient management.
Fact: It takes
about 3 months for the effect of LASER to set in. Rarely, bleeding may occur
inside the eyes immediately after LASER. This bleeding is a consequence of the
pre existing damage and would have occurred even if the patient had not been
treated and does not represent any poor management on the part of the doctor.
Myth 8: I have
had LASER treatment for diabetic retinopathy. My sugars are under control ever
since the treatment had started. So I do not need to go back to my doctor.
Fact: Diabetic
retinopathy is an ongoing condition just like diabetes. While control of
diabetes is a must to have the problem under control there is no guarantee that
the disease will not progress just because diabetes is under control. Therefore
it is essential that the patient gets himself/herself evaluated at regular intervals
to ensure that the problem is under control.
Myth 9: I have
had 2 injections inside my eye with no response. I think the medicine is
ineffective.
Fact: The
condition inside the eye maybe difficult to manage and may need multiple
injections. The injection helps in creating a suitable environment inside the
eye to ensure recovery from the damage caused due to diabetes. It improves
oedema inside the eye which may sometimes also be associated with improvement
in visual acuity. Some studies have also demonstrated that the administration
of these injections results in improvement in the quality of vision and life.
Needless to say, some damage might be beyond repair.
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