1. Diabetes can affect all organs of the body including the eye. Eye is affected in about one - fourth of the diabetics in their life time.
2. Major effect of Diabetes on the eye is on retina and is potentially blinding.
3. After 10 yrs of onset of D., eye is invariably involved. Eye involvement can be delayed by good control of D.
4. D.R. is a disease involving both eyes but they may be involved unequally.
5. Involvement of an eye is commonly associated with involvement of the kidney, so blood & urine tests must be done to rule out the kidney involvement.
6. D.R. has usually reached serious proportions before patient develops any symptoms due to D.R. Hence all diabetic patients must have at least yearly follow up by an eye specialist, preferably the retina surgeon.
7. Central, most sensitive part of the retina is called the macula, which is preferentially involved by D.R. This condition is called diabetic maculopathy.
8. Till today there are no definite known oral drugs useful for D.R.
9. The most useful treatment of D.R. is by LASER. Very late cases may need the incisional surgery.
10. Hypertension & kidney involvement if present should be controlled well to provide optimal benefit with laser therapy.
11. Before laser therapy for D.R. fluorescein angiography (F.F.A.) is mostly required to study the blood vessels of the retina which become leaky and weak due to D.. Laser destroys these leaking or weak blood vessels directly or indirectly.
12. In F.A., a fluorescent dye is injected into the vein of hand or forearm that reaches the eye by blood circulation. Most common side effect of fluorescein dye is nausea, vomiting and allergy. After F.A. dark yellow discolouration of skin and urine is normal and is only temporary.
13. Laser is done on an outpatient basis under topical anesthesia (no admission required in hospital) in 1 to 4 sittings each eye depending upon the degree & extent of involvement of the retina.
14. In majority of the cases, laser only delays the deterioration of vision without providing any gain in vision, rather after lasering for diabetic maculopathy cases, vision may slightly deteriorate.
15. Not all cases of D.R. require or respond to laser therapy and they may need additional laser later in life. Hence regular follow up every 3 - 6 months is required even after laser treatment. Some patients may require special injections (Anti-VEGFs like Avastin, Lucentis, etc.) to be given into the eye.
16. Cataract, glaucoma and eye muscle paralysis are also commoner in diabetics.