Diabetic Retinopathy

in StemSocial3 months ago (edited)

Hello to all and sundry,


It is a wonderful weekend over here and I certainly hope that even as you read this write-up, you are doing well and having a wonderful time? I for one feel great pleasure in having this opportunity to come your way once again with another health discussion concerning our ocular health and as usual, I do hope this helps someone out there and that my readers get to benefit from the knowledge.

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In the past few days, I have been treating some health conditions based on those I encounter at the hospital daily to help conscientize people about our eyes and the need to take their healthcare seriously. In one of the discussions, we talked about diabetic cataract and how diabetes generally tends to affect the eye in that regard and I did inform @agmoore that I gonna take further look into diabetes and the eye, and so for today, I want to continue with that. We are going to look at how diabetes affects our retina, stay tuned and enjoy the read.


Introduction


Diabetes as we have come to understand not only affects the eye but every other system within the body negatively. This can be attributed to the fact that glucose ought not to be in the circulatory system at high levels for a long period, which is why the system automatically converts them to a more storable form called glycogen. In diabetes, this process is affected because even as the system tries to do this the amount that still remains is quite high and sometimes the system is not able to even do this conversion.

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When this happens the concentration of glucose in the blood and cells affects nutrients and water distribution in the tissues and cells using osmosis and diffusion. Swellings may occur at different parts of the body, and lymphocyte functions are impaired causing difficulty in the healing process. Diabetics who are not particular about their condition could easily end up losing limb or limb function for fear of sepsis from wounds.

The same vain diabetic who is not particular about managing their condition well could also end up losing their sight to the conditions as the glucose impairs several reactions in the eye to go wrong resulting in the development of cataracts, the death of cells of the retina, bleeding into the eye, inflammatory processes starting, dry eye conditions coming about and a whole lot.


Diabetic Retinopathy


So what happens in diabetic retinopathy? Retinopathy is a term coined from the word retina which is basically the part of the inner eye responsible for vision. The retina is made up of 10 layers one of which include contains the rods and cones, which conversion of light energy from your environment into electrical impulses for interpretation by the brain, thus enabling vision. This process is known as phototransduction.

The cells of the retina are one of the most active in the entire human body hence the high demand for energy, nutrients, and oxygen by the minute. The retina obtains nutrition from the blood vessels that supply from the back and from through the choroid and the central retinal arteries. (Since we are not doing a Circulatory system we wouldn't go into details for this). These vessels as they branch off to feed the retina become smaller and smaller. The small sizes make it difficult for the high level of glucose to pass through.

Thus glucose tends to accumulate and block the vessels in diabetes, as the vessels get blocked cells are cut off from receiving the needed nutrition etc, they thus tend to die off in bits and pieces. In an attempt to keep the cells alive and things going the body tries to form new vessels out of the original ones to do the supplying, however in its haste, these vessels do not form well and end up weaker than the already affected original vessels.

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The new vessels start to bleed into the eye further disturbing the peace within the eye as well as the vision, the concentration of glucose ends up causing fluid to build up in the part of the retina known as the macula, this result in a condition known as macular edema. The issue with macular edema is that this part of the eye is responsible for central vision and so when this happens our vision becomes very bad, objects may even appear distorted and glasses may not do much to help in this situation.

As these processes continue to go on our vision continues to deteriorate until that point is reached where all may be lost or very little of our vision would be left. The headache with diabetic eye disease is that management through surgical means also becomes a headache as diabetes tends to affect wound healing, everything thus becomes a headache. The most important thing that we can do for our patients and for ourselves if we are patient is to ensure that we do well to manage our diabetes very well after diagnosis.

Many have had diabetes for so many years and have yet to have their eyes and vision affected in this way because they took their condition very seriously, checked their glucose level daily, ate only what was recommended, and stayed away from diets that ain't helpful to them. As health practitioners, nothing disturbs us more than a situation we know we can hardly do anything to help and so help us to help you, together we can save your sight and maintain a good healthy life.


Conclusion


Just as I informed agmoore sometime back, my intention is not to scare you but to make you aware of all the possible outcomes including the worst and best scenarios to guide you in your actions and inactions. Let's love our health, let's love our eyes and we should certainly love our sight.

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Remember to seek regular health care always, be in control of your health and whenever you are confused about something ask your healthcare provider do not just google your symptoms, we spent years in school for your benefit and we are always glad to be of use to you. I do wish each and every one of us a good time and a fruitful weekend. Be safe and stay blessed.


Further Reading

Enomoto, H., Sugimoto, M., Asami, S., & Kondo, M. (2022). Progress of Diabetic Macular Edema after Loading Injection of Anti-Vascular Endothelial Growth Factor Agents in Real-World Cases. Medicina (Kaunas, Lithuania), 58(10), 1318. https://doi.org/10.3390/medicina58101318

Umaefulam, V., & Premkumar, K. (2022). Enablers and Barriers to Diabetic Retinopathy Eye Care among First Nations and Métis Women. Diabetic medicine : a journal of the British Diabetic Association, e14995. Advance online publication. https://doi.org/10.1111/dme.14995

Elgafi, M., Sharafeldeen, A., Elnakib, A., Elgarayhi, A., Alghamdi, N. S., Sallah, M., & El-Baz, A. (2022). Detection of Diabetic Retinopathy Using Extracted 3D Features from OCT Images. Sensors (Basel, Switzerland), 22(20), 7833. https://doi.org/10.3390/s22207833

Milluzzo, A., Barchitta, M., Maugeri, A., Magnano San Lio, R., Favara, G., Mazzone, M. G., Sciacca, L., & Agodi, A. (2022). Do Nutrients and Nutraceuticals Play a Role in Diabetic Retinopathy? A Systematic Review. Nutrients, 14(20), 4430. https://doi.org/10.3390/nu14204430

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My husband had an eye operation for 2 times left and right eye beacuse of teridium.Now we are also waiting for the next schedule of his eye operation in catraract.We waited almost 6 months since its a public hospital.His sugar level last exam is 189 ,prior yo that his sugar level is 300.Is this a contibutory factor to his eye problem ? Sugar level?

Hello @dehai, I hope you are doing well? To answer your question, yes the sugar level is always a contributing factor when it comes to the eye, so long as the sugar level continues to be high the sugary will have to be put on hold to avoid surgical complications and wound healing complications.

Again, he may notice that anytime the sugar spikes the vision deteriorates, I am certain the surgery has been held back due to the sugar because then your husband could also easily develop posterior subcapsular opacities after the surgery.

For now my advice would be to have a co-management plan with your general physician and Ophthalmologist to keep it down. Also, if the cataract hasn’t matured, the surgery may be put on hold for a while. I hope this helps. Stay safe and have a fruitful week

[email protected] thank you so much As of this time we are wauting for his schedule of operation.I am also monitoring his sugar level.

That's good to hear, do let me know if there anything i can do to help or clarify for you and you can keep me updated on how things go too

While waiting for his operation to be scheduled in a public hospital, is there a drop that can use to apply? or remedy

Sugar levels are systemic and thus ought to be seen by a general physician, is it not a situation that drops can remedy. What i can advise is to take in lots of fruits and vegetables during this period, you may give him vitamin C supplements, it is the most powerful antioxidant with regards to the eye.

Yeah it affects the vessels , retina without a good vascularizarion it can be damaged
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