Diabetes is first among the diseases leading to loss of vision of the two eyes at a young age. Eye disorder is expected to occur in about 10 years after diagnosing the insulin-dependent diabetes, but many factors such as poor blood sugar control, arterial hypertonia, smoking, pregnancy, etc. can accelerate this process.
The increased amount of blood sugar, due to lack of insulin in the blood damages the small vessels (capillaries in the retina). On the one hand, they increase their permeability, which leads to haemorrhages and edema, and on the other retina nutrition is deteriorated. Tissue ischemia is developed, stimulating the formation of new dysfunctional vessels with thin walls, that can easily tear and bleed. These changes are generally called diabetic retinopathy.
The disease affects both eyes, though in unequal degrees. In a more advanced stage diabetic retinopathy causes sharp reduction of vision to complete loss of vision.
Symptoms: the disease has no early symptoms. When vision is reduced it is already too late and possibilities for the ophthalmologist are limited. That is why all people with diabetes and with no retinopathy should visit the eye doctor at least once a year. Those with proven diabetic retinopathy, depending on the form and stage, this period is much shorter: 6, 3 or 1 month. Often doctors can tell by the eyes if the patient has diabetes – he may have had it for years, but without knowing that.
What tests are needed to detect the disease:
- visual acuity test;
- tonometry – eye pressure measurement;
- dilated-pupil fundus examination;
- fluorescein angiography, so-called colour fundus photography;
- optical coherence tomography (OCT).
Treatment: the only proven treatment for diabetic retinopathy is the laser photocoagulation, destroying part of the retina affected by diabetes in order to maintain vision and delay disease progression. If laser photocoagulation is carried out in time, loss of vision can be reduced considerably and vision can be stabilised. Otherwise it will lead to massive haemorrhages, and the only treatment is the so called vitrectomy (link to vitreoretinal surgery). It is best if laser photocoagulation is performed after the fundus photography.
Burgas Specialised Eye Hospital own an eye scanner, which is the only one of its kind in the Southeast Bulgaria. The super modern device enables our ophthalmologists to identify even the smallest deviations and determine exactly the patient’s condition. The operating room is equipped with a composite and compound device for surgeries of the anterior and posterior eye segment, which is the only one of its kind in the Burgas region. Patients with diabetic retinopathy, to undergo surgery with us, are consulted by one of the most famous ophthalmologists in Bulgaria – Assoc. Prof. Dr. Borislav Dabov.