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Diabetic Retinopathy

India has the world’s second largest population of diabetes & hypertension Eye affection increases with duration of diabetes and with poor control.

Complications caused due to diabetes are

• retinopathy
• glaucoma,
• cataract
• increased risk of eye infections
• paralysis of one or more eye muscles,
• dry eye and
• affections of the optic nerve

Many a problem can be detected and treated even before symptoms develop. Treating it later may be more expensive and more importantly, less effective! The blood vessels of the retina are the only blood vessels in the whole body that can be viewed with a simple non-invasive technique (ophthalmoscopy). These blood vessels mirror the changes taking place in the rest of the body’s blood vessels.

The tiny retinal blood vessels in diabetics are more prone to leakages. This can result in
• leakage of blood in the retina (retinal haemorrhage) or
• into the jelly of the eye in front of the retina (vitreous haemorrhage).
• Fatty material, cholesterol etc may also leak into the retina, either in the centre or in the periphery. All leakages, whether of blood, fluid or cholesterol in the macular area will result in distorted vision or a drop in vision. This may be sudden, such as when bleeding occurs, or gradual, when fluid oozes slowly into the macular area.
• In case fluid containing protein leaks out into the retina, it tends to collect in the centre i.e. the macular area causing macular oedema.

. The aim of laser treatment is to preserve whatever vision there is left. Also, as the duration of diabetes increases, especially if it is poorly controlled, fresh hemorrhages and leakages can occur. This may necessitate repeated sittings of laser. Unfortunately, our retinal cells do not have the capacity to grow. Hence, whatever cells are damaged, will result in permanent loss of vision in the affected area.


Proliferative Diabetic Retinopathy can have the following features
• Neovascularization- means new vessel formation. This is worse as the new vessels are fragile causing more bleeding either on retina or in the vitreous cavity (Vitreous Haemorrhage).
• Vitreous Detachment & Tractional Retinal Detachment

Personal Care

A Patient with Diabetes should
• Keep strict control of Diabetes
• Poorly controlled Diabetics should go for 3 monthly retinal examination.
• Patient with good control of Diabetes should have 6 monthly checkups.


1. FFA (Fluorescent Fundus Angiography)- to look for leaking vessels and new vessels.

2. Laser treatment is given to seal these leaking vessels.
In Proliferative Diabetic Retinopathy to destroy all of the dead areas of retina where the blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to diminish or disappear.

3. Injections in Diabetic Retinopathy
• Kenacort Injection- It is a steroid which reduces the macular edema.
• Anti VEGF (Vascular Endothelial Growth Factor) injection –eg. Avastin, Macugen, Lucentis. These drugs are selective against VEGF and prevent formation of new vessels and also simultaneously reduce the swelling at macula.

4. Surgery- Vitrectomy for Vitreous Haemorrhage And Retinal Detachment Surgery

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