Diabetic Retinopathy in Upper Assam: How Diabetes Can Damage Your Eyes Without Warning

Diabetic Retinopathy in Upper Assam: How Diabetes Can Damage Your Eyes Without Warning

Most people think of diabetes as a condition of blood sugar. It is also a condition of blood vessels, and the eye has some of the finest blood vessels in the body. Over the years, high blood sugar can slowly damage them. When this happens in the retina, the result is called diabetic retinopathy.

The difficult part is that diabetic retinopathy usually does not announce itself. You can read the newspaper, watch television and drive, and feel that your eyes are fine, while changes are already under way at the back of the eye. That is why eye doctors ask people with diabetes to have their retina examined regularly, even when they see well.

This is not a reason to be afraid. Found early, diabetic retinopathy can be monitored and managed, and many people keep useful vision for life. This guide explains what the condition is, what to watch for, who is at risk, how it is checked and what treatment can involve. If you live in Dibrugarh or anywhere in Upper Assam, it also tells you where to start. You can read about our diabetic eye care service as well.

What is diabetic retinopathy?

The retina is a thin layer of light-sensitive tissue at the back of the eye. It works like the film in a camera: it picks up light and sends signals through the optic nerve to the brain, which turns them into the pictures you see. The retina needs a steady supply of blood from tiny vessels.

When blood sugar stays high for long periods, these vessels can weaken, leak fluid or blood, or become blocked. This damage is diabetic retinopathy. It affects people with type 1 and type 2 diabetes.

It is helpful to know that diabetes can affect the eyes in other ways too. Diabetes can bring on cataract earlier and is linked with a higher risk of glaucoma, and changes in blood sugar can cause short-term blurring by changing the shape of the lens. These are different from diabetic retinopathy, which is damage to the retina itself. Finding out which one you have needs an eye examination.

Early detection matters because the retina does not regrow. Treatment is mostly about protecting the vision you have, so the earlier a problem is found, the more options there are.

Why can diabetic retinopathy develop without warning?

In its early stage the damage is tiny. A few vessel walls bulge or leak in areas of the retina that are not used for sharp, central vision. Your brain also fills in small gaps, so you may not notice anything is missing.

Over time, the damage can spread. Leaking fluid can reach the macula, which handles the fine detail in the centre of your vision. Or the retina may lose its blood supply in patches and start to grow fragile new vessels. By the time you notice a change in sight, the disease may already be advanced.

Two points are worth remembering:

•      Clear vision does not mean a healthy retina. A dilated examination can see changes that you cannot.

•      Waiting for symptoms means waiting too long. Screening is meant to find the problem before the symptoms start.

Symptoms of diabetic retinopathy you should know

Early diabetic retinopathy often causes no symptoms at all. When symptoms do appear, they can include:

•      Blurred or fluctuating vision, where sight seems clear one day and hazy the next.

•      Floaters, which look like dark spots, cobwebs or threads drifting across your vision.

•      Dark or empty patches in your field of vision.

•      Difficulty reading, recognising faces or seeing in dim light.

•      Colours that look faded or washed out.

Blurred vision does not always mean diabetic retinopathy. It can come from a change in blood sugar, cataract or a need for new glasses. Whatever the cause, any change in your vision deserves a proper examination.

Who is at risk of diabetic retinopathy?

Anyone with diabetes can develop it. It is not limited to people whose sugar is poorly controlled, though control makes a real difference. The main factors are:

Having several of these factors does not mean you will lose vision. It means regular eye examinations matter even more for you.

When should people with diabetes get their eyes checked?

Guidance from eye and diabetes bodies, including the American Academy of Ophthalmology, suggests the following starting points:

•      Type 2 diabetes: a first retinal examination around the time of diagnosis, as the disease may have been present for some years before it was found.

•      Type 1 diabetes: a first examination a few years after diagnosis (guidelines commonly say within three to five years), or earlier if your doctor advises.

•      Pregnancy in a woman who already has diabetes: an examination early in pregnancy, with follow-up as advised.

After the first examination, how often you return depends on what the retina shows. People with a healthy retina or very early changes may be seen every one to two years, or yearly as many doctors prefer. If changes progress, check-ups become more frequent, from every few months to within weeks for advanced disease. Your own plan also depends on your age, how long you have had diabetes, how well it is controlled and your doctor’s judgement.

So rather than copying a schedule from the internet, ask your eye specialist for a personal follow-up plan and keep every appointment, even when your sight feels fine.

How is diabetic retinopathy diagnosed?

The tests are usually quick and painless. Your specialist may use some or all of the following:

•      Dilated retinal examination. Drops widen your pupils so the doctor can look carefully at the retina and optic nerve. Your near vision stays blurred and light feels bright for a few hours, so do not drive yourself home afterwards. Bring a family member.

•      Optical coherence tomography (OCT). A scan that takes cross-section pictures of the retina. It is especially useful for finding swelling at the macula. OCT is listed on our retina care page.

•      Retinal photography and fluorescein angiography. Where clinically needed, a specialist may advise retinal photographs, or an angiogram in which a dye is injected into a vein to show leaking or blocked vessels.

Not every patient needs every test. Your eye specialist chooses based on your findings.

What are the stages of diabetic retinopathy?

Doctors group diabetic retinopathy by severity. The three terms you are most likely to hear are:

Severity varies from person to person, and the two eyes can differ. Only a qualified eye specialist can tell you which stage you are in and how it should be managed.

What are the treatment options for diabetic retinopathy?

Treatment depends entirely on what the examination shows. Many people do not need injections, laser or surgery. The usual options are:

Injections, laser and surgery help to protect vision and reduce the risk of complications. They cannot promise a cure or a guaranteed outcome, and they do not replace good control of diabetes. Retina treatment at Drishti is described on our retina care page.

Can diabetic retinopathy be prevented?

You cannot always prevent it, but you can lower the risk and slow its progress. This is what helps most:

1.     Manage your diabetes as advised by your doctor, including medicines, diet, activity and regular blood tests.

2.     Keep blood pressure and cholesterol in the range your doctor sets for you.

3.     Have regular retinal examinations, even when your vision is clear.

4.     Follow your treatment and follow-up plan and do not stop treatment because you feel well.

5.     Get new visual symptoms checked promptly.

6.     Stop smoking, if you smoke.

Good control lowers the risk but does not remove it entirely, which is why screening stays important however well you are doing.

Diabetic eye care in Dibrugarh and Upper Assam

For people in Dibrugarh, Tinsukia, Sivasagar, Dhemaji, Lakhimpur and the surrounding districts, and for families travelling from Arunachal Pradesh and Nagaland, the main hurdle is often not knowing a check-up is needed, or putting it off because work, farming or travel gets in the way. A routine retinal examination takes little time compared with the years of vision it helps to protect.

Drishti Netralaya has served Upper Assam for over 36 years. Our retina team is led by vitreo-retinal surgeons, listed on the our doctors page. According to our retina page, routine dilated examinations and diabetic retina screening are offered at our Dhemaji City Center and Machkhowa Vision Center, while retinal injections, laser treatment and surgery are carried out at the main hospital in Dibrugarh, near Amolapatty Railway Gate.

Please confirm current services and appointment times on our diabetic eye care page or contact page before you travel.

Practical tips for your visit: bring your previous eye records, a list of your medicines and your latest blood sugar reports, and bring someone with you, because dilating drops make driving unsafe for some hours.

Frequently asked questions

Can diabetic retinopathy occur without symptoms?

Yes. In the early stages most people notice nothing, and vision can stay clear while the retina is already changing. This is why a retinal examination is recommended even when your eyesight feels normal.

Can diabetic retinopathy cause blindness?

It can cause serious vision loss if it is not found and managed in time, and it is one of the leading causes of vision loss in working-age adults with diabetes. The encouraging part is that regular screening and timely treatment can lower the chance of severe vision loss. Your specialist can tell you what applies to your eyes.

How often should people with diabetes get their eyes checked?

There is no single interval for everyone. Guidelines suggest that people with type 2 diabetes have a first retinal examination around the time of diagnosis, while people with type 1 diabetes usually begin a few years after diagnosis. After that, the gap depends on what the retina shows, your diabetes control, pregnancy and your doctor’s advice. Ask your eye specialist for a personal plan and keep to it.

Can diabetic retinopathy be reversed?

Existing retinal damage usually cannot be reversed. What treatment and good diabetes control can often do is slow the progression and protect the vision you still have. Some swelling at the macula may improve with treatment, but this varies from person to person.

Does everyone with diabetes develop diabetic retinopathy?

No. Not everyone with diabetes develops it, and the risk is lower with good control of blood sugar, blood pressure and cholesterol. The risk rises with the number of years you have lived with diabetes, so everyone with diabetes needs regular examinations, whatever their current sugar readings.

Can diabetic retinopathy be treated?

Yes, it can be managed. Treatment depends on the findings. Early disease may only need careful monitoring and better control of diabetes, blood pressure and cholesterol. More advanced disease may need injections into the eye, laser treatment or, in some cases, surgery. Your eye specialist decides what is right for you.

What is the difference between diabetic retinopathy and diabetic macular oedema?

Diabetic retinopathy is damage to the blood vessels across the retina. Diabetic macular oedema (DME) is swelling in the macula, the small central part of the retina responsible for sharp vision. DME can occur at any stage of retinopathy and is a common reason for blurred central vision.

When should someone with diabetes seek urgent eye care?

Seek care on the same day if you have a sudden loss or drop in vision, a sudden shower of new floaters, flashes of light, or a dark curtain or shadow across your vision. Do not wait for your next scheduled check-up.

Can people with diabetes have an eye examination even if their vision is clear?

Yes, and they should. Clear vision does not mean a healthy retina. A dilated examination can find changes that you cannot feel or see yourself, long before your eyesight is affected.

Does blurred vision in a person with diabetes always mean diabetic retinopathy?

No. Blurred vision may also come from changes in blood sugar, which can temporarily change the shape of the eye’s lens, or from cataract, glaucoma or a need for new glasses. Only an eye examination can tell the cause, so do not assume or ignore it.