On the occasion of World Diabetes Day, experts from IMO Miranza Group, an international reference clinic in ophthalmology, warn about. the importance of regular visits to the ophthalmologist.. They can be key to early diagnosis of eye diseases, including diabetes, before the patient may even notice the symptoms of the pathology.
According to Dr. Xavier Subirás, ophthalmologist expert in the ocular complications of diabetes, “we could say that the early stages of this disease are, in many cases, silentbecause the patient does not notice obvious symptoms. However, in a routine ophthalmologic examination we can detect one of the first signs of diabetes: bleeding in the retina in the form of a spot and stain, a type of hemorrhage inside the eye, small and irregular, which does not cause poor vision, but easily detectable by the ophthalmologist. Thanks to this, we can diagnose diabetes early and, at the same time, address and control the evolution with better systemic and visual prognosis”.
These bleedings are due to diabetes causing. progressive and cumulative damage in the blood vessels of the organism and the retina in particular. Precisely, this is a highly vascularized neural tissue, whose role is key in eye-brain visual transmission.
In this regard, the main complications of diabetes in the eyes are proliferative retinopathy and diabetic macular edema, which involve, among others, a progressive degeneration of the photoreceptor cells that allow us to see. These diseases can, in turn, lead to other related eye pathologies, such as an aggressive type of glaucoma or retinal detachment.
When diabetes already manifests itself at the ocular level, they may begin to visual disturbances may begin to appear that should alert the diabetic patient: gradual loss of vision, especially if it is abrupt, blurred vision or distorted object outlines are some of the most common and may occur at the same time or in isolation.
Likewise, Dr. Subirás adds, “There is a symptom that is red vision and it is due to hemorrhages inside the eye. Also the vision of large flying flies, a common symptom in the general population, which may also be produced by these saccades. In this case, they correspond to blood clots whose shadows are projected on the retina. Occasionally, patients notice these sensations separately or go from one to the other in a matter of hours or days, but that does not mean that the person is out of risk or experiencing improvement”. For any of these symptoms, it is essential to consult a retina specialist.
Another aspect to take very much into account, along with the identification of symptoms, is the importance of self-care of the patient. “I believe that we health care providers play a key role in educating the diabetic patient. And we physicians must know how to explain which signs should alarm us. A clear example is the rate of glycosylated hemoglobin in the blood (cumulative value) and not the glucose level, which is a point indicator. We now know that above 6.5-7% indicates that the patient has a high chance of developing diabetic retinopathy and that only 2-3 months of cumulative damage with these values is enough to cause retinal damage”, continues the ophthalmologist.
There are different ways of approaching the treatment of the patient with diabetes, depending mainly on the severity and evolution of the disease. For this purpose, ophthalmologists have therapeutic strategies that they use in isolation or in combination, such as lasers, intraocular injections or surgery. In this regard, Dr. Subirás stresses that “it is very important that the approach is carried out by a specialist with extensive experience in the treatment of diabetic patients, since, for example, there are times when it is better not to touch the eye”. “In those cases, we prefer to be conservative, control that the patient’s vision is maintained and treat only those cases that are going to worsen without proper treatment. I would say that there is no standardized and universal therapy, but that we must assess the best strategy for each patient”, he concludes.