Diabetic Retinopathy

Diabetic retinopathy is a disease in which the blood vessels of the retina of the eye get damaged due to diabetes. It is the most common cause of vision impairment and eventual loss in people suffering from diabetes. Complications such as swelling of an area of the retina called macula may also occur, a condition known as DME (Diabetic Macular Edema). Though patients of diabetic retinopathy may experience only slight vision impairment at first, it can lead to blindness eventually. 

People suffering from type I or type II diabetes are at high risk for developing diabetic retinopathy. The longer one may have been suffering from diabetes, the greater the chances of developing this disorder. Poor control of blood sugar also puts you at higher risk for this disorder, as excessive sugar can block and damage the blood vessels in the retina. The eye attempts to grow new blood vessels, which may not develop properly. Pregnancy may worsen diabetic retinopathy, so pregnant women suffering from diabetes must also have their eye sight assessed. 

You could be suffering from early or advanced diabetic retinopathy. In early diabetic retinopathy, blood vessels of the retina start getting weaker, leading to tiny bulges in the smaller vessels and dilation of the larger blood vessels. Fluid and blood may leak out of these vessels into the retina, and nerve fibres may also swell. 

This leads to advanced diabetic retinopathy, whereby blood vessels get completely blocked and the eye tries to form new blood vessels, which are not properly formed. The accumulation of new blood vessels leads to formation of scar tissue, and may also cause pressure build up due to improper fluid drainage, which can damage the optic nerve and eventually cause blindness.​​

In the beginning, symptoms of diabetic retinopathy may not be very prominent. However, the symptoms may progress rapidly, affecting your vision over time. Blurred vision is one of the earliest symptoms you will encounter if you are suffering from diabetic retinopathy.

Other signs and symptoms of diabetic retinopathy are:

  • Blurred or reduced vision.

  • Darkened or distorted images.

  • Spots or strings in your visual field.

  • Fluctuating vision.

  • Dissimilar images in both eyes.

  • Difficulty seeing at night.

  • In extreme cases, permanent vision loss (blindness) may occur.

Sudden changes in vision must not be ignored and must be assessed by a doctor, especially if you have diabetes. It is also advisable for diabetics to routinely visit an ophthalmologist (eye specialist) to have an eye examination to ensure there are no problems with vision. ​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​​

Besides a medical history which highlights that you are diabetic and the specific nature of your symptoms, a detailed eye exam will help diagnose diabetic retinopathy. An eye dilation exam is conducted, for which special drops to help your pupils dilate are used. This helps your doctor look inside your eye with the help of special instruments. The doctor will be able to identify abnormal blood vessels, signs of swelling, bleeding or any other symptoms within the eye specific to diabetic retinopathy. 

Besides this, your vision may also be assessed with the help of an eye chart, tests to check your eye pressure to evaluate the possibility of glaucoma (tonometry), and tests for cataracts will also be conducted. Imaging tests to get cross-sectional images of the retina (Optical coherence tomography) will also be conducted, as well as tests using dyes to take images of the inside of your eyes (Fluorescein angiography)

If you have diabetic retinopathy, your doctor will recommend the most suitable treatment plan for you, depending on your symptoms and how far the disorder has advanced. You can be assured of receiving multidisciplinary care at The Aga Khan University Hospital for diagnosis and treatment of your diabetic retinopathy.​

Early detection and treatment of diabetic retinopathy can reduce your chances of blindness significantly. However, early symptoms of this disorder are hard to detect. That is why, if you suffer from diabetes, you must have an eye examination annually to detect the disease in the earlier stages. People who suffer from diabetes are also advised to keep their blood sugar levels normal, as this serves a preventive purpose against diabetic retinopathy. 

Treatment of diabetic retinopathy cannot cure this disorder completely, but can help you manage the symptoms or slow its progress. The following are the treatment option available for you:

  • Laser treatment (photocoagulation): This treatment aims to create small burns in the retina with the purpose of stopping any leaks from abnormal blood vessels. This helps the blood vessels shrink and disappear. Although side vision may get affected by this treatment, central vision will be protected. Photocoagulation treatment may be focused at one point in the retina or scattered throughout, depending on how advanced your disorder is.

  • Removal of parts of vitreous gel in the eye which have become cloudy because of fluid leakage (vitrectomy): In cases of severe bleeding into the vitreous gel of the eye, the cloudy gel is removed and replaced with a clear saline solution. The eye will have to be covered with a patch after the procedure and special eye drops may be prescribed. 

  • Light mask treatment using special light therapy.

  • Corticosteroids that help reduce swelling: These may be prescribed individually or in conjunction with one of the treatment options discussed above. 

  • Anti –VEGF (anti vascular endothelial growth factor) eye injections. These injections inhibit the production of the protein VEGF, preventing the growth of new blood vessels. 

Some of these procedures may have to be conducted under local or general anaesthesia. Talk with your doctor at The Aga Khan University Hospital about any treatment before you try it to find out how useful it might be.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.