What is diabetic eye disease?
Diabetic eye disease (DED) is normally used for a group of eye diseases that patients with diabetes mellitus may get as a complication of diabetes. Diabetic eye disease can be the cause of severe vision loss or blindness, above all. Diabetic eye disease includes diabetic retinopathy, cataract and glaucoma.
What is Diabetic Retinopathy?
Diabetic retinopathy is one of the complications of diabetes out of tripathy. Diabetic retinopathy occurs when hyperglycaemia (high blood sugar levels) causes damage to the cells at the back of the eye, known anatomically as, the retina. Diabetic retinopathy is a leading cause of loss of vision.
The chief culprit behind diabetic retinopathy is the changes in the vessels supplying blood to the retina. In some patients diagnosed with diabetic retinopathy, blood vessels undergo swelling and as a result, there is leakage of the fluid. In other patients, there is abnormal growth of new blood vessels on the surface of the retina. A healthy retina is required for good vision.
Incidence of diabetic retinopathy in India
In the Indian subcontinent, only limited data are available on the prevalence of diabetic retinopathy in the general population. The Chennai Urban Rural Epidemiology Study reported the prevalence of diabetic retinopathy in urban Chennai to be 17.6% in the diabetic population, and the Aravind Comprehensive Eye Study reported the prevalence of diabetic retinopathy in rural South India to be 10.5%.
Screening for diabetic retinopathy
Screening for diabetic retinopathy is must as severe retinopathy can cause sudden onset of blindness. Diabetic retinopathy needs early identification and treatment. The chief purpose of screening for diabetic retinopathy is to reduce the risk of vision loss in patients diagnosed with diabetes mellitus.
Each and every diabetic patient who is in the age group of 12 or over should undergo screening for diabetic retinopathy once a year. The screening process involves examining the fundus (back of the eyes) and clicking photographs of the retina. The screening is in a position to detect diabetic retinopathy at an early stage before any changes in the eye-vision is noticed.
Causes of Diabetic Retinopathy
Over the time, hyperglycaemia (high blood sugar content) causes blockage of the minute blood vessels that provide nourishment to the retina, thereby cutting off the blood supply. As a result, the eye attempts to grow new blood vessels. The new blood vessels don’t undergo proper development and undergo leakage easily.
Signs and Symptoms of Diabetic Retinopathy
At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, it can cause blindness.
Allopathic Treatment for Diabetic Retinopathy
The treatment for diabetic retinopathy actually depends on the stage the disease has reached. As an instance example, if diabetic retinopathy has been identified in the early stage, one can prevent it from getting worse just by controlling sugar levels.
If the patient has been diagnosed with advanced diabetic retinopathy, one may need to undergo laser surgery or injection therapy in order to prevent further damage to the vision.
Ayurvedic Treatment for Diabetic Retinopathy
As such there is no description available for diabetic retinopathy in ancient Ayurvedic texts. Following measures can be taken for possible treatment of diabetic retinopathy:
- Lepa over eyes
- Netra seka or Netra dhara
- Netra tarpana(if no active bleeding)
- Oral medicines e.g. Saptamrita lauh, Triphla ghrita, Mahatriphla ghrita, Patoladi ghrita, Jivantyadighrita, Triphla churan, Shatavari churan, Rasayan chikitsa.
- Shiro lepa or pichu with sheet stambhan aushadhi
Ayurveda Research Studies
A study was undertaken on Diabecon (a commercial polyherbal formulation), in patients with diabetic retinopathy. 32 with diabetic retinopathy were given Diabecon at a dose of 2 tablets, thrice daily for a period of 3 months. The patients were monitored according to eye testing for diabetic retinopathy subjects and Airlie House Classification.
Diabecon effectively helped in the resorption of retinal and vitreal haemorrhage as well as soft and hard exudates, and showed a promise in retardation of components producing venous dilatation, microaneurysm and promotion of neovascularisation.
An open labelled randomized controlled clinical trial was conducted on 60 patients divided in 2 groups (30 in each group). Gr. A (Tab. Retinox 1 OD), Gr.B (Mahgnivati Wati, 500mg BD) daily for 6 months in addition to OHA as advised by Physician.
Changes were observed at 6 months compared with baseline in functional factors like dark adaption test, Visual acuity, quality of Life, Intra Ocular Pressure (IOP), and Fundus photographs. Assessment of degree of severity of NPDR was done as per –SCI-027 Guidelines for DR Royal College of Ophthalmology 2005.
Wilcoxon- sign rank test, & Manwhitney U test was applied to evaluate micro-aneurysm, Dot & blot haemorrhage, soft exudates, Cotton Wool Patches for intra group and inter group. T test for Best corrected visual acuity.
Both groups exert significant effect on mild to moderate NPDR.”Mahagniwati” was more effective in mild to moderate NPDR
Preventing Diabetic Retinopathy
In order to reduce risk of developing diabetic retinopathy, it’s vital to maintain optimal levels of blood sugar, blood pressure and above all cholesterol and triglycerides, level. A good control over these prevents diabetic complications.
Other steps that you can take to help prevent retinopathy include:
- Attending your annual screening appointment
- Controlling your blood pressure and cholesterol levels
- Exercising regularly
- Giving up smoking
- Informing your general practitioner if any change is noticed in the vision
- Losing weight (if you’re overweight) and eating a healthy, balanced diet
- Taking your medication as prescribed
Salunke AS. An ayurvedic polyherbal formulation (Mahagni wati) in the management of non proliferative diabetic retinopathy (NPDR): A preliminary study. J Diabetes Metab 2014, 5:10.
Kant S, Sahu M, Sharma S. Effect of Diabecon (D-400), an Ayurvedic Herbomineral Formulation on Diabetic Retinopathy. Indian Journal of Clinical Practice 2002: 12: 49-56.
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