The increasing number of diabetes mellitus cases pose major health care challenges in India. According to the WDF, diabetes is the leading cause of blindness worldwide. In India it is estimated that one in five people who have had diabetes for more than 10 years will develop diabetic retinopathy.

The main stages of diabetic retinopathy are:

(i) non-proliferative - background diabetic retinopathy, characterized by the development of occasional small blisters (microaneurysms) caused by enlarged capillaries and small haemorrhages on the surface of the retina. Moderately severe to very severe non-proliferative diabetic retinopathy is also known as pre-proliferative diabetic retinopathy.

(ii) proliferative - symptoms of which include: blurred or double vision; reduced vision; and dark or floating spots.

In the non-proliferative stages, abnormal blood vessel permeability results in the leakage of water, blood cells, proteins and fats into the surrounding retinal tissue. At this stage, diabetic retinopathy usually shows no symptoms unless accompanied by diabetic macular edema.

People progress from pre-proliferative to proliferative diabetic retinopathy when new blood vessels grow from, and across the retina in response to lack of oxygen delivered by the original vessels. This is called neovascularisation. However, these new vessels are very weak and are even more likely to break and bleed into the clear gel (the vitreous) that fills the back cavity of the eye, blocking vision. Scar tissues may also form near the retina, detaching it from the back of the eye and resulting in blindness. Diabetic Macular Edema

This is a common complication associated with diabetic retinopathy. It corresponds to a swelling in the macula, one of the areas of the retina. When some of the small blood vessels in the retina are blocked, the surrounding ones dilate to compensate for this. The dilated vessels are generally leaky and fluid builds up in the macula, which in turn causes the macula to swell and cease to function. It is the most common cause of visual impairment in patients with non-proliferative retinopathy. Loss of vision can occur suddenly and treatment is not very successful.

Treatment

'There is no pharmaceutical therapy available at present that stops the progression of diabetic retinopathy. However, lasers are widely used in treating diabetic retinopathy.. Laser is an intense and highly energetic beam of light that emerges from a light source and is focused on the retina' said Dr. Shivaram.

Nayana is thus actually rekindling the light in many eyes, which would otherwise have become sightless.

Source: Amit Dwived (CNS).