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Disease profile: Diabetic retinopathy

Diabetes — partially owing to the genetic risk unique to those in India and partially due to lifestyle factors — is one of the fastest growing health conditions in the country. However, as many as 60.5 percent of Indian diabetics do not properly control their blood sugar. The consequences of this practice, among others, can include diabetic retinopathy — a condition wherein blood vessels within the eyes are damaged, which can go so far as to cause blindness.

If properly managed, an individual affected by diabetes can live a normal life. This may involve regulation of blood sugar, either through regular insulin use or, in the best case scenario, simply through alterations in lifestyle factors such as reducing sugar intake.

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Prevalence of diabetic retinopathy

India accounts for a significant portion of the world’s 347 million diabetics. According to the World Health Organization (WHO), 69.2 million Indians were living with diabetes in 2015. This number has been projected to rise to 98 million people by 2030.

Eye conditions are estimated to affect around one in seven Indians with diabetes. This would place the overall figure at around ten million individuals affected by a condition that can potentially progress to blindness, marking it as a considerable health burden.

 

Symptoms

Diabetic retinopathy, as well as a number of other conditions which fall under the umbrella term of diabetic eye disease, all cause some degree of vision loss in those with diabetes. The typical cause of these diseases is chronic high blood sugar.

High levels of blood sugar can, over time, cause damage to smaller blood vessels. For some, this may occur within the retina. This is an internal component of the eye that detects incoming light, converting it to signals sent through the optic nerve to the brain. The eye is a sensitive and highly precise organ, as such any degree of damage can cause significant alterations to vision.

As such, the following symptoms may occur in cases of diabetic retinopathy: spots or dark strings within the field of vision, blurred vision, fluctuating vision, impaired colour vision, and dark or empty areas in one’s vision. Finally, diabetic retinopathy can result in total vision loss.

 

Prevention and treatment

Prevention of diabetic retinopathy falls in line with the standard management methods of diabetes. Control of blood sugar and use of insulin in more severe cases can limit the impact of prolonged high sugar and blood pressure levels on the blood vessels in the eye, limiting the risk of the development of retinopathy.

The treatment methods for those who have developed the condition may be all but out of reach for many in rural India. Photocoagulation is one option for treatment. This uses laser treatment to create minute burns that prevent leakage of fluid from burst or damaged blood vessels within the eye. A similar process, vitrectomy, has the same outcome, but uses surgical incisions to drain the fluid.

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