It is sad, but in recent years, patients with diabetes mellitus are increasingly visiting an eye specialist. But still more regrettable that basically the cause such visits are directions endocrinologists on inspection eye bottom.
But on their own initiative, our office is rarely seen by anyone. And in vain. Patients simply not are aware the whole importance such a research, and therefore neglect to them. But in the group the sick sugar diabetes includes both young and old, and people medium years.
Diabetes mellitus is one of the most common diseases of the endocrine system. Disease dangerous the fact that at her arise heavy violations practically in of all organs and systems of our organism. In her basis lies generalized defeat vessels.
During the examination, specialists find changes in the kidneys, retina, mucous membranes of the eyes, stomach and intestines, muscles, placenta, tissues of the nervous system, pancreas. Universal defeat vessels is an the cause such scary complications like stroke, heart attack myocardium, gangrene lower limbs, stomach and intestinal bleeding . Special often are amazed vessels kidneys and eyes.
Therefore, a consultative diabetic center operates in our region at the regional clinical hospital, and in the outpatient clinic of the diagnostic center there is a treatment room for diabetic retinopathy. What about need to know to everyone?
Sick sugar diabetes prone to inflammatory diseases century in the form of eczema, blepharitis, blepharoconjunctivitis , halaziona . Regularly emerging itch century testifies to the beginning inflammatory process. More often Total diseases dermal covers at sugar diabetes are explained lowered resilience of the body different kind of infections and intoxications.
Changes in the vessels, tissue of the mucous membrane of the eyeball and eyelids at the first stages can be seen only with the help of a slit lamp – a diagnostic device, available in each ophthalmologic office. Defeat horny shell eye It has dystrophic character and treated such a disease highly is bad.
Already at a young age, diabetic cataracts develop in diabetic patients. She is often accompanied by sluggish inflammation and surgical intervention requires highly scrupulous and correct preoperative preparation. Otherwise case receive a good the sharpness of view after deletion cataracts not will succeed.
Main same changes at diabetes detected in the vascular shell eyes that happen inflammatory, dystrophic and vascular character. To what this can to lead?
Hemorrhages into the vitreous body, into the retina, to an increase in intraocular pressure and glaucoma, to retinal detachment and, as a result, to blindness. Reasons vascular changes, developing at sugar diabetes are violations composition blood (most dangerously increase content cholesteroland his fractions which leads to higher viscosity blood and slow blood flow as well as insolvency vascular walls).
That is why every patient with diabetes should attend an oculist at least twice a year. After all Eye a only body in which vessels can review and make judgment about their condition in others organs. I hope anyone not need to to prove that than earlier identified what – what change, the easiermaintain order not only eyes, but the entire organism to conduct prophylaxis possible complications .
And yet, it is important not only compensation Sahara blood, but also the maintenance of him numbers on one level. Sharp all level Sahara leads to defeat small vessels and how consequence, to hemorrhages, well, if to small.
But even if there are no gross changes in the tissues of the eyes, they are still an indicator of the state of blood sugar levels.
Him a change in the direction enhance or downgrades leads to loss spice view, makes the sick to complain on the bad glasses or deterioration view.
Only these sensations temporary. Remember: “to each level Sahara of blood match their points.
Regular visits to an ophthalmologist are very important not only for the health of the organs of vision, but also for the general condition of the body. Besides addition, it only reliable the way to reveal ophthalmic diseases and save the good sight and on long years.
So, for example , when violation carbohydrate exchange ophthalmologist quite often diagnoses changes vessels retina well in advance before identify sugar diabetes . it is explained big opportunities organism to compensate such a violations .
A missed eye examination is also a missed chance to check for potential threats to health.
After all on the first sight most usual ophthalmic inspection will help to reveal violations health before disease will cause irreparable harm eyes and body .
This will relieve you not only from the danger of serious complications, but also unnecessary material costs.
And if required operational intervention on eyes, spend preparing for it together with an endocrinologist .
What is diabetic retinopathy ?
Diabetic Retinopathy is a complication of diabetes mellitus that damages the retina (retina). The retina is the photosensitive and transmissive layer of the fundus of the eye. In order for a man to see the light beam to pass into the eye through the cornea, lens and vitreous (gel-like substance inside the eye, which is included in the optical system of the eye) and to reach the retina.
An image trapped on the retina through the fibers of the optic nerve is transmitted to the brain. The yellow spot (macula), which is located in the central part of the retina, allows you to see the details, as well as read.
As a result of changes caused by diabetes, small blood vessels (capillaries) can become blocked and begin to leak blood. This causes swelling in the center of the retina and the formation of new blood vessels in the fundus. However, new blood vessels have an incomplete wall, which can cause their permeability, with the result that the eye is filled with blood. This is hemorrhage (hemorrhage) of the vitreous body.
Diabetic retinopathy is classified according to the fundus changes, and their number and degree of severity in each of the eyes may be different:
- Backgroundretinopathy – early development of the disease and rarely occurs before 8-10 years of the disease. Visual acuity is normal, and there is no danger that it will decrease. However, if multiple small hemorrhages, fragile blood vessels and exudate appear, this indicates the development of retinopathy and requires more frequent monitoring (every 6-12 months).
- Preproliferativeretinopathy – this degree of development of retinopathy is characterized by the expansion, crispiness and permeability of the retinal veins. Hemorrhages in the fundus occurs more, and they can be more extensive. There are a large number of different exudates.
- Proliferative and advancedretinopathy – If the blood vessels are blocked, the retina remains without oxygen and nutrients. To restore the blood supply and nutrition of the retina, new, imperfect blood vessels begin to grow in the fundus of the eye. They are fragile and can cause vitreous hemorrhages. In the case of small hemorrhages, vision becomes blurred (lines and floating haze appear before the eyes), extensive hemorrhage already seriously interferes with vision. New blood vessels contribute to the formation of connective tissue, which can lead to retinal detachment and loss of vision.
Retinopathy may occur:
- In young, insulin-dependent diabetic patients
- In diabetic patients compensated by diet
- In diabetic patients undergoing treatment with pills
- In compensated diabetic patients suffering from diabetes for a long time.
Diseases can not be avoided, however, compliance with the requirements for diabetics slows the occurrence of complications (including retinopathy ).
- It is important to follow a diet.
- Take your medicine in time
- Control your blood pressure
- Avoid being overweight
- Do not smoke
- Avoid alcohol
Strict adherence to the recommendations for diabetics does not eliminate the changes that have occurred, but will slow down the aggravation of the process!
Will eye control prevent changes from occurring?
This will not prevent them, however, early detection of changes in the fundus will allow timely start treatment and prevent vision loss. Until puberty, retinopathy does not occur. However, since puberty, each diabetic should control his orbital fundus once a year, with retinopathy , twice a year, and more often on the recommendation of an eye doctor.
What is eye control?
Eye control is the control of visual acuity and eye research with a slit lamp and a special magnifier. Before examining the fundus of the eye, drops are instilled into the droplets, expanding the pupil and allowing both the fundus and the changes there to see. With an extended pupil, vision (especially close) is temporarily blurred, and, for example, it may be difficult to drive a car. Therefore, arriving at the reception to the eye doctor, it is not desirable to be the driver himself.
Do I need to conduct additional research?
If necessary, also do color photo the fundus of the eye, applying for this special camera. The photograph shows changes in the retina at the moment, which will allow later comparison and observation of the patient. To clarify the causes of reduced vision sometimes requires fluorescent angiography (FAG), which is a study of the retina with a contrast agent in order to identify the state of the blood vessels. This test is mainly used for three reasons:
- For an accurate diagnosis
- To refine the fundus area that requires direct laser treatment
- To determine the cause of loss of vision by the patient (for example,diabetic maculopathy)
How to treat retinopathy ?
The first and main possibility is to reduce the permeability of blood vessels and destroy new vessels by focusing the laser beam on the affected retina. Pan coagulation retina is a 2000-4000 fundus burns. The treatment is carried out on an outpatient basis, but it is often required to repeat it.Laser treatment is necessary to preserve vision, and not to improve it. Blindness can be prevented in 80-90% of cases.
Laser treatment is required when the eye doctor detects neovascularization of the retina, or if there is a likelihood of it appearing after some time. Usually in patients with diabetes mellitus 10-15 years (with a strong decompensation of diabetes even earlier). Another indication for laser treatment is the capillary permeability near the macula and in its surrounding area.
Does surgery (vitrectomy) improve vision?
This is an operation during which the vitreous body is removed by microsurgical instruments and a microscope and the fundus of the eye is cleaned. Replacing the turbid vitreous body with a transparent medium allows the light to reach the retina again, and thus the ability to see is partially restored. And yet the quality of vision with the normal is not comparable. It may take weeks and months before vision improves. In the case of severe retinopathy, the stopping of the disease can be considered an achievement.
Are there any aids that would help with reading if vision deteriorated?
Those diabetics whose vision has dropped so much that they see objects only from a distance of a few meters can also be helped. To continue their daily activities, they can use both a simple magnifying glass and various electronic aids. Employees of the Tallinn Rehabilitation Center for the Blind constantly help visually impaired advice, training and training in the use of aids.