We continue part 5 of our interview with Dr. S.S. Gill, Consultant Ophthalmologist at Hospital Fatimah, about Diabetes Mellitus and eye complications (diabetic retinopathy).
What are some other steps that diabetics can take apart from regular eye checks in order to help reduce their risk of developing diabetic eye complications?
Apart from good diabetic and hypertension control, it is advantageous to control blood cholesterol levels. Dr. Gill shares that he is sometimes asked by diabetic patients whether high cholesterol levels make a difference or not in slowing down the diabetic eye complications.
To this, he says that although studies have shown some conflicting results, it is clear that maintaining or lowering blood cholesterol levels is still a priority for people with diabetes. This is because high cholesterol increases the risk of heart attack and stroke. It is therefore good to keep cholesterol levels low in order to prevent vision complications in diabetics because high cholesterol can result in blood vessels in the retina (nerve tissue at the back of the eye) getting blocked.
Dr Gill also encourages diabetics to quit smoking because smoking cigarettes is a risk factor for diabetic retinopathy. The blood pressure-raising effect of smoking has clearly been shown to increase the risk of diabetic eye complications (diabetic retinopathy). Smoking therefore cannot be taken lightly. Maintaining a healthy weight and giving up smoking are all part of good diabetes control. Remember, nerve damage, kidney damage and cardiovascular diseases are more likely in smokers with diabetes.
Can you tell us what happens when a diabetic patient goes for an eye check-up to detect diabetic retinopathy?
The first check is to determine what clarity of vision a diabetic patient has. This is done as soon as the patient registers at the eye clinic.
A visual acuity test is done using a chart test that measures how well he or she can see at various distances.
For many patients who have never checked their eyes and come in only when they have blurred vision, they may be surprised to find that they are not able to read any of the letters on the chart.
Dr. Gill emphasises that it is always better to detect diabetic eye complications early before a person reaches a stage of complication where they are unable to read the chart.
After the visual acuity test, the patient will then be seated at a slit-lamp to be checked by the ophthalmologist. This is where the preliminary eye examination, to look at the front of the eye, will be done.
The eye pressure (intraocular pressure) will also be checked at this stage to look out for other associated conditions such as glaucoma that can also cause poor vision and blindness. Cataracts (clouding of the lens) can also be detected at this stage and later confirmed when the dilated eye examination is done.
The ophthalmologist will also look at the retina when the eye has been dilated to examine if there are any changes, indicating the presence of diabetic eye disease. The patient will then be advised and treated accordingly.
Next issue: Dr. Gill elaborates on some of the signs of diabetic eye disease that are seen during examination. For more information, contact Gill Eye Specialist Centre, Hospital Fatimah (05-5455582), or email firstname.lastname@example.org.