Diabetic eye complications highlighted on World Sight Day

In observance of World Sight Day, a global initiative to promote eye health awareness, we delve into the pressing issue of diabetic eye complications, a silent threat to vision. Malaysia, with a staggering 68.3% surge in diabetes cases, holds the dubious distinction of having the highest prevalence in Asia.

Dr Tara Mary George, Consultant Ophthalmologist and Medical Retina Specialist at Sunway Medical Centre, Sunway City (SMC), provides insights into the intricacies of diabetic eye problems, their potential consequences, and the measures available to address them.

With 1 in 5 Malaysians affected by diabetes, understanding and managing diabetic eye complications is of paramount importance.

Understanding diabetic eye complications

Many individuals with diabetes underestimate the seriousness of diabetic eye complications. A recent study reveals that only 58.6% of diabetic patients were aware of the possibility of eye problems at the time of diagnosis. Even more concerning is the fact that just 43.0% knew that routine eye checks were essential upon diabetes diagnosis.

Dr Tara elucidates the impact of diabetes on the delicate blood vessels in the retina, the eye’s focal point, which can result in irreversible vision loss. Diabetes can also affect other aspects of ocular health, leading to conditions like cataracts or dry eyes, although these conditions can often be managed without causing permanent vision impairment.

The prevalence of diabetic retinopathy in Malaysia has seen a steady increase over the years, exceeding rates in countries like the UK and Japan. Diabetic retinopathy, characterised by complications such as vitreous haemorrhage and macular edema, poses a dual threat to vision.

Macular edema involves swelling of the central part of the retina, while vitreous haemorrhage is bleeding within the eye’s gel-like substance. Both conditions can seriously jeopardise one’s eyesight.

Early warning signs and routine eye examinations

Diabetic retinopathy can develop stealthily, often without noticeable symptoms. Alarmingly, a recent study found that nearly 30% of type 2 diabetic patients in Malaysia already had retinopathy in their initial eye test.

Dr Tara underscores the significance of not waiting for symptoms to appear before seeking the advice of an eye specialist. Timely and regular eye check-ups are essential, including comprehensive retina evaluations, which can be performed using advanced retinal cameras that eliminate the need for pupil dilation. These devices are widely accessible, making screening swift and convenient.

Dr Tara provides a comprehensive strategy for averting vision loss in diabetes:

1. Early Diagnosis: Regular medical check-ups are crucial, particularly for those with a family history of diabetes.
2. Routine Eye Screening: Annual eye screenings are imperative for all diabetes patients, even in the absence of apparent issues.
3. Effective Diabetes Management: Maintaining well-controlled diabetes significantly reduces the risk of diabetic retinopathy. Monitoring HbA1C levels is vital, with a recommended target below 7.5.

In recent years, screening and testing services have become more accessible, with many private hospitals and government health centres offering these services. Optometrists and paramedical staff, when properly trained, can also administer screenings and refer individuals to ophthalmologists when necessary.

Addressing concerns about pre-diabetes, Dr Tara clarifies that eye complications typically do not arise at this stage. However, it presents an opportunity to prevent full-fledged diabetes by adopting preemptive measures and maintaining healthy blood sugar levels.

Dr Tara outlines systemic treatment, intra-vitreal injections, and laser treatment. These interventions have yielded remarkable improvements in patients’ quality of life. The choice of treatment depends on individual circumstances and severity.

As we commemorate World Sight Day, let us prioritise our eye health. Regular eye screenings are swift and uncomplicated procedures that can safeguard our vision.