Retina is the innermost layer of the eye and is light sensitive in nature.
Retina is the innermost layer of the eye and is light sensitive in nature. When we see an object, the light rays pass through the lens in our eyes and fall on the retina. They get converted into neural signals/impulses here and the optic nerve carries these visual stimuli to the brain that translates them back as images. Now if you are a Harry Potter fan, then consider the retina as the platform 9 ¾ (the entry point to the world of magic). If something goes wrong here, then nothing reaches your center for imagination (the brain) and your vision to the beautiful world stays completely cut-off.
Diabetic retinopathy is one of the most commonly associated findings in diabetic patients. Diabetes affects the small blood vessels of the retina and weakens them, leading to bleeding in the eye, swelling of theretina, increased eye pressure and many other ways. Gradually it leads toblurring of vision, which if left untreated may lead to permanent vision loss.A lot of patients do not have any vision problem in the beginning, even thoughthe diabetic retinopathy may be very severe. This is the ideal window oftreatment where the vision is not greatly compromised and early prompttreatment can be more gratifying for the patient. Gradually it leads toblurring of vision, which if left untreated may lead to permanent vision loss.
Diabetic retinopathy and associated vision loss:
The two main reasons for vision loss inDiabetic Retinopathy.
Like any other tissue, retina is dependent on blood supplyfor its nutrients. The blood rich in nutrients comes through the retinalarteries, gets distributed into the capillaries and reaches the retina. Thenutrients are used by the retina and the waste products of metabolism isdistributed to the retinal veins and taken out of the eye.
In vein occlusions, the outflow passage is blocked partiallyor completely. When that happens, due to the backflow changes, the pressure inthe veins increases and leads to leaking of blood and fluid from the blockedveins and into the retina. If this involves the macula, there can be swellingof the macula and vision is affected.
Normally, one eye is affected. Gradual/ sudden blurring of vision. Normally, there is no pain.
However in advanced cases, slight pain may be there
The treatment has to focus on the eye as well as thesystemic cause that lead to the vein occlusion.
Macula is the central and the most visually important areaof your retina. With increasing age, the macula gets affected due to variousreasons. In elderly patients, the macula is likely to get more degenerated andhence the vision is affected. With ARMD, central vision is more affected whereas peripheral vision (i.e. Side vision) is not affected.
This is how a patuient with macular degeneration would see as opposed to a normal person.
There are two types of ARMD :
Many people don’t realize they have ARMD until their vision is very blurry. This is why it is important to have regular visits to a retina specialist. He/she can look for early signs of ARMD before you have any vision problems.
What are the risk factors for ARMD ?
There is no cure for Macular Degeneration. However, vision loss can be slowed or stopped. Early treatment is important to control the disease before too much vision is lost.
Dry ARMD patients have been found to benefit from taking a combination of certain nutritional supplements which may slow down the progression of ARMD. This was found in a large studies called AREDS and AREDS 2. Eye-healthy foods like Dark green leafy vegetables, yellow fruits and a balanced, nutrient-rich diet have been shown beneficial for people with ARMD. Food items rich in vitamins such as spinach, tomato, carrots, oranges etc might be consumed too.
Wet ARMD patients need active intervention and treatment. In these patients, the mainstay of treatment isanti-VEGF injections. This helps to reduce the growth of new immature blood vessels and reduces the fluid and blood leakage from them. Such patients might need multiple injections and need regular follow up with the retina specialist.
Home Monitoring with Amsler’s Chart is very essential to look for progression.
Keep the Amsler grid in a place where you see it every day. Many people keep an Amsler grid on their refrigerator door or on their bathroom mirror.
In good light, look at the grid from about 12–15 inches away. Be sure to wear your reading glasses if you normally use them.
Cover one eye. Look directly at the dot in the center of the grid with your uncovered eye. Notice if any of the lines look bent or wavy. See if any part of the grid looks blurry, dim, or out of shape.
Now cover your other eye and test your vision this same way again.
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