Myths and facts on diabetic retinopathy
Dr P Tandava Krishnan
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.
