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Are you diabetic? Address all your concerns about diabetes and retinal involvement.

Retinal image showing retinal changes due to diabetes
Retinal image showing advanced diabetic retinopathy

1) I got diagnosed with diabetes last week. My physician says I need a retina check- up but I have no eye symptoms at all. He says I need an eye- check up because diabetes may have affected my retina. But it’s only been a week since I was diagnosed with diabetes.

  • First, you have a very good physician who knows the importance of a retina check-up. You are in good hands. 

  • Although you got diagnosed diabetes recently, the actual duration you may have had high sugar levels may be much longer. Since the duration is unknown, you will need a retina check- up at the time of diagnosis to know if diabetes has affected your retina. 

  • Diabetic retinopathy is considered a major complication of diabetes because it has the potential to cause vision loss. Based on the stage of diabetic retinopathy, the retina specialist will tell you how frequently you need a retina check- up. The intervals may be spaced as far apart as one year to being closely spaced at 3 months.

2) My retina specialist has said I have a macular problem due to diabetes. I am receiving frequent eye injections for this. Every time I visit the retina specialist, she gets a scan of my eyes and advises injections. I have had five injections in each of my eyes. I am concerned about how long I need to continue to take these injections.

  • It seems like you may have diabetic macular edema. Macular edema is a swelling in the center of the retina caused by long standing diabetes. If left untreated, macular edema can cause irreversible vision loss. 

  • To prevent this, it is important to keep monitoring it by taking regular scans of your macula, this test is called optical coherence tomography (OCT). An OCT tells us how much edema there is, whether you need injections and how well you are responding to the injections given in the previous visits. 

  • Diabetic macular edema is a chronic problem and needs frequent monitoring and timely injections to keep it in check. Delay in follow up and missing injections may make it difficult to treat after a point. If a particular injection is not helping to reduce the macular swelling, the doctor may switch the treatment and try other injections available in their repertoire or even consider laser.

  •  Apart from regular checkups, scans, and injections it is important to know that macular edema is influenced by multiple factors, such as duration of diabetes, HbA1c levels, other medical problems such as increased blood sugars, lipid levels, sleep apnea (indicated by excessive snoring at night) and obesity with a sedentary lifestyle. Hence a holistic approach to treatment is needed with strict control of multiple factors.

Shortsighted and suffering from flashes and floaters? What you must know!

Retinal image showing retinal detachment

I have been wearing glasses since class 8. I am 24 years old now. Recently I have started noticing small spots in my field of vision. Sometimes I even see a flash of light that are fleeting. The black spots and flashes of light are increasing in frequency for one week. Why is this happening?

  • Considering that you are wearing glasses since many years, it seems that you have myopia (minus powered glasses). Myopic individuals tend to develop black spots in their field of vision. These look like mosquitoes and some people may find that it is annoying and interferes with their vision. 

  • Flashes of light are even more concerning. Flashes usually mean that there is a hole or tear formation in your retina. If left untreated, the tear may cause a full- blown retinal detachment which requires major surgery. To prevent such complications and to detect early retinal problems, all myopic individuals must undergo retinal screening examination by a retina specialization at least once every year if not every six months. 

  • Also, in case of floaters and more importantly flashes, an immediate examination is necessary to detect tears in the retina. If there are tears, the retinal specialist may advise for an urgent laser treatment to prevent complications of retinal detachment. A stitch in time saves nine. In this case, a timely barrage goes a long way in preventing major retinal problems. 

  • In case you do develop a retinal detachment, you may notice a sudden veil- like shadow in your field of vision. This is also an indication to see your retinal specialist immediately. A freshly detected detachment has better chances of visual recovery after surgery. If you ignore these symptoms, it is possible that even after future surgery, the vision may remain poor despite multiple surgeries. 

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