Half of people with diabetes develop this serious ocular complications, which can cause blindness.
One of the most common causes of eye disease in diabetics, both type 2 and 1 (the insulin-dependent), is diabetic retinopathy. The problem is the lack of symptoms in the early stages of the disease, but if detected early, its effects are devastating. For the diagnosis will only need the patient’s medical history and perform a noninvasive test: the study of the fundus.
“View” flies fly in the field of vision and light flashes, trouble reading or distinguishing the environment at night, pain or pressure in one or both eyes, double vision, blurred or distorted, or have difficulty discerning objects on the ends the visual field. These are some indicators that reveal a problem in the retina of people dabéticas. One of the possible causes: diabetic retinopathy. In this situation, you must go to the ophthalmologist without delay.
What is it?
The retina is a layer of light-sensitive tissue that is located on the back of the eye. It acts as a processor: the images pass through the lens of the eye and focus on it, which turns them into electrical signals and, through the optic nerve, reach the brain. By function, any alteration is very harmful. The lesions in the retina of the eye are one of the most serious complications in the development of diabetes: 25% of blindness in Spain are caused by diabetic retinopathy.
Maintain high levels of blood glucose and high levels of blood pressure (which is common in people with diabetes) can damage the small blood vessels in the retina, which weaken and prevent adequate blood supply. This may be of varying severity in both eyes. In some cases it comes at a time extravasation of fluid in these capillaries, which worsens the situation and leads to vision loss.
Its development is directly related to the years of development of diabetes and patient age. There are stages in which accelerates the progression, such as puberty and pregnancy when it is most likely to get out of control blood sugar levels.
The diagnosis is made through a study of the eye, ophthalmoscopy, which examines changes in the retina, blood vessels, fundus and optic disc, which is the beginning of the optic nerve. Although this scan is painless, it is somewhat uncomfortable as it is administered eye drops causes pupil dilation, rapid and reversible manner. This causes, at times, and for a period of time, which depends on the individual-, clouding of vision and bright lights bother. Therefore not recommended to drive after the test. Once both pupils dilated, and with a light source that is in the instrument itself, is lit inside the eye through the iris and displayed all structures with magnifying glasses.
Recommendations for the diabetic patient
To reduce the risk of diabetic retinopathy, is critical with complete surveillance of the factors that aggravate the injury of blood vessels in the retina. Among them, a careful control of diabetes and blood glucose, levels of blood pressure and cholesterol, as well as avoiding the consumption of snuff and alcohol. There is evidence that smoking prevents the retina reach the required amounts of oxygen.
All treatment guidelines agree that a healthy diet, capable of maintaining a healthy weight, and the assiduous practice of physical exercise are important pillars in maintaining the health of the whole population, especially in diabetics, for whom these guidelines form part of the treatment of their disease. The experts urge eye checkups on a regular basis (although there are no symptoms), along with good visual hygiene.
Some recommendations for maintaining good eye health are corrected using glasses if necessary and appropriate sunscreen, and wear protective filters when working with computer or eye protection to avoid burns or wounds, not self-medicate with eye drops, except by prescription, not to overstress visual or reading and work with optimal light conditions.
Demonstrated effectiveness of photocoagulation
Faced with diabetic retinopathy, the ophthalmologist may recommend laser photocoagulation, a procedure used to remove the spilled blood vessels in the eye and slow vision loss, and a drug treatment that decreases. For this reason, it is vital to conduct a thorough screening of patients likely to develop it. There are two studies that show that laser therapy: the Diabetic Retinopathy Study (DRS) and the Early Treatment Diabetic Retinopathy Study, ETDRS (early treatment study of diabetic retinopathy).
The first, conducted on a sample of 1758 patients, indicates that it reduces the loss of vision that causes the disease: it causes severe visual loss in 15.9% of untreated eyes, compared to 6.4 % in treated eyes. The benefit is lower in patients with low-risk, between those with high risk. This latter type of control patients, 26% progressed to severe vision loss, compared with 11% of those treated with laser.
The ETDRS also established the benefit of laser photocoagulation surgery in eyes with macular edema, accumulation of fluid from the retina-significant. Other results of this study show that aspirin does not prevent the development of proliferative diabetic retinopathy does not reduce the risk of visual loss, but does not increase the risk of vitreous hemorrhage, when blood is concentrated in the center of the eye (vitreous gel).
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