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Diabetic Retinopathy

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diabetic

 

Latest figures released by the Ministry of Health reveal that one person in three in Mauritius (thirty per cent of the population) suffers from diabetes mellitus (or sugar diabetes), which means that the level of glucose in their blood is abnormally high. This causes blood vessels in the body to become fragile and liable to rupture. When this occurs in the retinal blood vessels, visual impairment may result; this is called diabetic retinopathy.

Diabetic retinopathy is one of the commonest causes of blindness in the world and the most common cause of blindness in developed countries.

Approximately 12% of people who are registered blind and partially sighted each year throughout the world have diabetic eye disease. At any one time, up to 10% of people with diabetes will have retinopathy requiring medical follow up or treatment. Unfortunately, we have no figures for the number of people who have become visually handicapped through diabetes in Mauritius because of the lack of a Register for the Blind and Partially Sighted.

Diabetes can also affect other organs and the presence and the severity of retinopathy may be an indicator of increased risk of other general complications such as ischaemic heart disease, kidney disease or diabetic neuropathy (which contributes to male impotence and diabetic foot disease).
The blood vessels in the retina can leak and haemorrhage into the eye resulting in visual problems in two possible ways. Firstly, bleeding into the vitreous may restrict the passage of light through the eye, especially if heavy. Secondly, that part of the retina, which is fed by the ruptured blood vessel, will die due to lack of oxygen and nutrients. Hence it will become incapable of passing visual messages onwards and there will be a corresponding blind area in the field of vision. If a large number of blood vessels break in a particular area, there will be a large patch of missing vision.

A person's remaining useful vision will depend on the position of the affected areas and this varies from one diabetic to another. Damage around the centre of the retina will lead to a central defect in the vision. Generally, the sight is described as if looking at a jigsaw with pieces missing. The pattern of these missing pieces differs from person to person, depending on where the haemorrhages are.

It is therefore most important for a diabetic to have regular eye check-ups. The eye care practitioner will screen for diabetic retinopathy and will refer for laser treatment, if and when necessary. There is a strong misconception locally that laser treatment makes the condition worse. Many diabetics will refuse to have laser done because they know of friends or relatives whose vision has gone worse after laser treatment. In such cases, It is most likely that laser treatment was done too late, either because the person tried to postpone it as much as possible or because eye check-ups were not done regularly and diabetic retinopathy went undiagnosed. It is important to stress that laser treatment forms an important part of treatment of diabetic retinopathy and that the eye doctor will only recommend it when truly necessary.

Other possible ocular complications of diabetes are changes in the power of the eyes, hence frequent changes in glasses required when diabetes is poorly controlled, early cataracts, inflammation of the eyes and secondary glaucoma. The key point to remember is that diabetics should have an eye check up at least once every year.

Disclaimer of Medical Liability

Whilst we have taken great care to gather correct information and to keep it current, we cannot guarantee its accuracy and completeness.

The information provided should never be considered a substitute for professional health care by a qualified doctor or other health care professional, which will be tailored to the patient's individual circumstances. We cannot take responsibility if you rely on this information alone.