Vitreo – Retina superspeciality department at the institute is capable of handling complicated Retina disorders.
With the emerging need to attend to retinal problems effectively, we also believe in prophylactic treatment for various early stages retinal problems.
Early detection and early intervention is also helpful to prolong the rapid deterioration of the vision.
Facilities at Wavikar Eye Institute for Retinal Treatment.
- We routinely run diabetic retinopathy clinic where in screening & early prevention of complication is targeted.
- Diagnostic tools like OCT, Fundus camera for FFA.
- Well equipped Operation Theatre & VISU 210 microscope.
- Reticare keratosystems for Vitrectomy surgeries equipped with endoillumilatior.
- Green laser for laser treatment.
- Facilities for intravitreal Avastin & Lucentis injection.
- PDT Laser (Photo dynamic therapy).
Diabetic Retinopathy Why with WEI?
- Experienced well trained consultants and support staff.
- Latest equipments like fundus Fluorescein Angiography, OCT (Optical Coherence Tomography), Green (Argon) laser and Suture Less Vitrectomy etc.
- In depth counseling and guidance regarding your disease, care as well as your treatment.
- Unique “Wavikar Experience” through compassionate and humane care.
Diabetic Retinopathy Clinic
Diabetes: – Diabetes is a disease characterized by increased sugar level in blood either because of inadequate secretion of insulin or improper processing of if by the body.
Other problems that may develop are:
- Cataracts — cloudiness of the eye lens
- Glaucoma — increased pressure in the eye that can lead to blindness
- Macular edema — blurry vision due to fluid leaking into the area of the retina that provides sharp central vision
- Retinal detachment — scarring that may cause part of the retina to pull away from the back of your eyeball.
Diabetic retinopathy is one of the vascular (Blood-vessel related) complications related to diabetes. It is due to damage of small vessels and so is called a “microvascular complication”. Kidney disease and nerve damage due to diabetes are also microvascular complications. Large blood vessel damage (also called macro vascular complications) includes heart disease and stroke.
Diabetes retinopathy is the leading cause irreversible blindness in industrialized nations, if retinopathy is not found early or is not treated, it can lead to blindness.
- Most often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.
- Symptoms of diabetic retinopathy include:
- Blurred vision and slow vision loss over time
- Shadows or missing areas of vision
- Trouble seeing at night
- Many people with early diabetic retinopathy have no symptoms before major bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams.
There are 3 stages of Diabetic Retinopathy
Background diabetic Retinopathy.
- Initial stage of diabetic Retinopathy.
- Presence of micro aneurysms (weakening of the blood vessels, leading to swelling of the blood vessels), hemorrhages (bleeding through the blood vessels), exudates (lipid deposits) or oedema (collection of fluid beneath the retina.)
- Vision is usually not affected until the macula is involved. If Macula is involved (known as diabetic maculopathy), then the patient will experience slow gradual progressive reduction in vision, for distance and near.
- There is no pain and no outward symptoms like bloodshot eyes, irritation or discharge.
Pre-proliferative Diabetic retinopathy.
- Develops in some eyes which initially show only simple background diabetic retinopathy.
- Patients in this stage should be watched closely since a significant number of people develop proliferative diabetic retinopathy.
Proliferative diabetic retinopathy.
- This type of retinopathy develops because of an increasing lack of oxygen to the eye from vascular disease. Vessels in the eye are thinned and occluded and they start to remodel.
- New abnormal vessels spread over inner surface of retina and may even grow out into the vitreous.
- These blood vessels frequently bleed into the vitreous (Know as vitreous hemorrhage) blocking the light from reaching the retina. Hence clouding the vision.
- The doctor usually waits for the blood to absorb; if it does not then Vitrectomy (surgical removal of blood) may be needed.
- It is experienced as black spots and cobweb like structures seen floating in front of the eye.
- If a large bout of hemorrhage occurs patients will experience sudden decreased in vision. If blood is in small quantity and remains fluid in nature, patient would experience vividly red liquid moving back and forth.
- Here, it is important to address the risks factors that can worsen the occluded vessels. Smoking cessation, hypertension control, cholesterol management and glucose control must take place in order to stop the progression of new vessels from forming.
- Annual eye check up is mandatory for all diabetic patients:-
- Once the symptoms arise immediate check up & more frequent follow ups are necessary. Symptoms of diabetic Retinopathy are Black spots in your vision, flashes of light, holes in your vision & blurred vision.
- Examination of the eye after dilatation of pupil by ophthalmoscope.
- FFA (Funds Fluorescein Angiography ):- Method of evaluating the patency of retinal and choroidal blood vessels, Fluorescein dye is injected into a vein then subsequently photographs of the eye are taken i.e. photographs of fundus as the dye circulates are taken.
- Ultrasonography (B Ascan) of the eye. Transmission of high frequency sound waves into the eyes, which are reflected the ocular tissues and displayed on screen so that internal structures can be visualized in eye with opaque media. Ultrasonography indicates the changes that are taking place in the vitreous hemorrhage, dense cataract, and corneal opacity. B scan helps us to evaluate such eyes and plan for surgeries.
- ICG: – Another type of Angiography of the vessels in the I C G (Indocyanine green is a dye that lights up when exposed to infrared light.
- Infrared light is used to take pictures of the back of the eye visualizing retinal blood vessels and choroidal blood vessels.
- OCT: – OCT uses light waves slicing through tissue layers in the back of the eye they produce a back scattering that converts into high resolution cross sectional images of the retina, macula and optic nerve, with this new medical imaging technology nerve, with this new medical imaging technology clinicians have another painless, precise diagnostic tool.
- LASER stands for light Amplification by Stimulated Emission of Radiation.
- Laser beam is energy that comes from special light source; it is focused on to the diseased area in the retina. The heat energy seals and destroys the abnormal blood vessels. The aim of this treatment is to protect the patient’s most important central vision, sacrificing if necessary some of the less important side vision.
- The laser treatment stabilizes the progression of diabetic retinopathy, periodic follow up is important to check any further progression is there.
- One has to remember that vision lost due to diabetes is very difficult to restore.
- The doctor may ask for a Fundus fluroscein angiography to be done before deciding about the laser because as it enables the doctor to evaluate the leakage in the retina.
- Laser treatment is painless procedure. In most cases are an OPD procedure and not a surgical procedure.
- Extent of diabetic retinopathy plays an important role in deciding the number of sittings required.
- You could have Blurred vision, Mild watering, Redness after laser treatment, they are usually temporary.
- Vitrectomy is another surgery commonly needed for diabetic patients who suffer a vitreous hemorrhage (bleeding in the gel-like substance the fills the center of the eye). During a vitrectomy, the retinal surgeon carefully removes blood and vitreous from the eye and replaces it with clear salt solution (saline). Patients with diabetes are at greater risk of developing retinal fears. And detachment, Tears is often sealed with laser surgery. Retinal detachment requires surgical treatment to reattach the retina to the back of the eye. The prognosis for visual recovery is dependent on the severity of the detachment.
- Even though retinopathy cannot be eliminated completely. Still the severity of the damage can be minimized, if diabetes is well within control and if the treatment has been started early.
- In more than 60% of cases, the vision can be saved if the treatment with laser has been given in time & eliminate the need for more complicated surgical procedure.