How diabetic retinopathy is silently stealing vision in India – Firstpost

As the burden of diabetes continues to rise in India, diabetic retinopathy has emerged as one of its most debilitating complications—often leading to irreversible vision loss if left undiagnosed. On the occasion of raising awareness about diabetic eye disease, we spoke to Dr Rakesh Seenappa, Regional Head of Retina Services at Dr Agarwal’s Eye Hospital (Bengaluru) to understand how diabetic retinopathy develops, its warning signs and the latest treatments available to control it.

Excerpts:

What is diabetic retinopathy and can vision be restored once it progresses?

Diabetic retinopathy is a vascular disease of the retina caused by blockage of the small retinal blood vessels. This disrupts blood flow and leads to complications such as vitreous haemorrhage, retinal detachment, chronic macular edema, and vascular occlusion, all of which can severely impair vision. While vision can be partially restored in advanced stages, full recovery is often not possible. The retina is nerve tissue and it cannot regenerate once permanently damaged. We can only recover the tissue that is still viable and functioning.

Why is diabetic retinopathy often detected late or overlooked in diabetic patients?

Diabetic retinopathy is often overlooked because many people are unaware of the condition and its risks. There is also a shortage of specialist doctors who can diagnose retinal damage in its early stages. In some cases, other eye conditions like cataracts may block the view of the retina, making detection more difficult. Additionally, patients and doctors often prioritise other systemic complications of diabetes, which leads to delays in regular eye check-ups.

Are there early warning signs of diabetic retinopathy that people should watch out for?

Yes, there are early warning signs of diabetic retinopathy that people should be aware of. These include a gradual reduction in vision that worsens over time, frequent changes in eyeglass prescription, and the appearance of blind spots or defects in the visual field. Some individuals may experience double vision or notice floaters—small shapes or specks that seem to drift across their field of vision. Distorted vision is another sign, where straight lines may appear curved or objects may look unusually large or small.

How high blood sugar damages the eyes and other causes of diabetic eye disease

High blood sugar damages the eyes over time by converting into toxic oxidative radicals and forming cholesterol deposits. These harmful byproducts disrupt the microvascular structure of the retina, leading to diabetic retinopathy.

In addition to high blood sugar, other contributing factors include high blood pressure, elevated cholesterol levels, and existing retinal conditions—all of which can accelerate retinal damage and increase the risk of vision loss.

How common is vision loss due to diabetes in India and globally? Are younger people with diabetes also at risk or is it mainly a concern for older adults?

The prevalence of diabetes in the general population is around 11%. The prevalence of diabetic retinopathy among them is around 16%, of which 3.6% have sight-threatening diabetic retinopathy changes. Yes, younger people with diabetes are also at risk of retinopathy, even more than the elderly population.

At what stage of diabetes should people start getting their eyes checked regularly?

The current guideline recommends that all individuals newly diagnosed with diabetes should undergo a retinal examination. If the retina appears normal during the initial check-up, annual follow-ups are advised. However, if diabetic retinopathy is detected, treatment and follow-up frequency will vary based on the severity and stage of the condition.

Are there any lifestyle changes that can help reduce the risk of diabetic retinopathy?

Lifestyle changes which sight reduces the risk of diabetic retinopathy a regular exercise, balanced diet, regular intake of diabetic medicines, avoiding alcohol and cigarettes controlling other systemic conditions such as hypertension and high cholesterol levels and frequent and regular eye check-ups.

What are the latest advancements in treating diabetic retinopathy?

The latest advancements in the treatment of diabetic retinopathy include:

Newer molecules: Ongoing research in intravitreal injections has led to the development of more efficient drugs for treating retinal haemorrhages and macular edema.

Surgical innovations: Techniques such as micro-incision vitrectomy surgery and the use of advanced 3D visualisation systems during retinal operations are now available, improving surgical outcomes and precision.