Diabetes and The Eye
An increasing incidence of diabetes mellitus poses a major health problem in India. The contributing factors are:
- An inappropriate diet, high intake of fat and carbohydrates
- Sedentary lifestyle.
Diabetes may affect both the young (type I) and the old (type II). The latter type is far more common.
Regardless of the type of diabetes, many diabetics develop a complication called diabetic retinopathy, a change in the retinal blood vessels that leads to loss of vision.
How does diabetes affect the eye?
Diabetes causes weakening of the blood vessels in the body. The tiny, delicate retinal blood vessels are particularly susceptible. This deterioration of retinal blood vessels, accompanied by structural changes in the retina, is termed diabetic retinopathy and will lead to loss of vision.
Diabetic retinopathy is gradual in onset and is related to the duration of diabetes. High blood glucose levels, high blood pressure and genetics influence the development and progression of diabetic retinopathy.
Treatment
Parents often get the false impression that a child may “outgrow” the problem. If a child’s two eyes are pointed in different directions, examination by an ophthalmologist is necessary to determine the cause and to begin treatment. The goals of treatment are to preserve vision, straighten the eyes and to restore binocular vision. Treatment of squint depends on the exact cause of the misaligned eyes. It can be directed towards unbalanced muscles or other conditions which are causing the eyes to point in two different directions. After a complete eye examination, including a detailed study of the inner parts of the eye, an ophthalmologist can recommend appropriate optical, medical or surgical therapy.
Non-surgical treatment - spectacles
Some squints are caused by refractive errors. In such cases, squint can be corrected by prescribing proper spectacles.
Surgical treatment
Pre operative Post operative Most patients require surgical correction. Surgery is done under general anaesthesia in children and under local anaesthesia in cooperating adults. To undergo general anaesthesia the child should be free from acute illness. Parents should inform the doctor if the child is having any systemic problems such as cardiac disease or epilepsy.
Routine investigations before surgery include a blood test and an X-ray of the chest.
- Surgery is done either on both eyes simultaneously or on one at a time. Surgery is done on eye muscles situated outside the eyeball. The surgery is done on the white portion of the eyeball.
- The eyeball is not opened.
- The principle of surgery is to weaken the stronger muscle and strengthen the weaker muscle. Either one or several muscles may be operated upon, depending on the type and severity of squint.
- Eye is bandaged for one day after surgery.
- After surgery, eye drops are to be used for about one month.
- Oral medication is not required except in a few cases.
- Hospital stay is only for two days.
- First follow-up visit will be one month after surgery.
- If amblyopia is present frequent follow-up appointments for a longer duration
are required. - It is unnecessary to restrain the normal activities of the child.
Treatment does not stop with surgery. Glasses may have to be continued to maintain clarity of vision. Patching therapy may be needed to be continued for some time after the surgery.
Squint is not a sign of good luck. It affects your child’s vision and appearance;
» Loss of vision is preventable if squint is treated as early as 1 to 2 years of age.
» As the child grows older, it becomes more difficult to treat squint and regain the lost vision. However, cosmetically straightening the eye is possible at any age.
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