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Speciality Diabetes Eye Centre

All of us are aware that India is infamously known as the diabetes capital in the entire world. Being a diabetic eye disease specialist, I have realized that the missing link in the treatment of any diabetes related with health issue is; the lack of knowledge about the disease itself and unawareness about the complications and consequences it can have upon one’s body organs.
Even if few patients have basic knowledge about the disease, they don’t have the clarity on how to tackle the disease, in order to prevent the complications .

Peeping into the mind of a Diabetes Patient

Lack of clear knowledge about the disease, makes one apprehensive of many things like how do I ensure sugar control? Will I have to always refrain from the food I like? will I die because of diabetes? Will I become blind because of diabetes? All these negative stream of thoughts increases stress resulting in fluctuation of blood sugar levels.
I believe that, educating these patients appropriately in time and in a hopeful manner is the need of hour, which will naturally motivate them to follow the lifestyle modifications required to prevent various diabetes related complications.

What is Speciality Diabetes Eye Clinic

Diabetes can affect every part of eye right from eyelid margin anteriorly to optic nerve posteriorly. A routine eye checkup done for non diabetic patient may not be sufficient for a diabetic patient. This is why the idea of specialty diabetic eye clinic emerged to give due importance and attention deserved by these patients.

What’s special about SDEC?

Once The diabetic patients walking into Asian eye hospital is identified, a detailed registration form is filled including parameters like

  • Hemoglobin %age (Hb)
  • Fasting blood sugars(FBS)
  • Post Prandial Blood sugars (PPBS)
  • HbA1c (glycosylated hemoglobin percentage which gives us an idea of average blood sugar control in last 3 months)
  • Blood Pressure(BP)
  • Diabetic Nephropathy status
  • Alternative therapies and lifestyle modification etc. is filled.

Primary eye check up

A primary eye check up and optometry check up includes additional check up of meibomian gland disease (MGD), dry eyes (leading to eye strain, stickiness, redness), extra ocular motility (to look for diabetic vasculopathy related muscle paresis), pupil examination (optic neuropathy and glaucoma), gonioscopy in a diabetic patient. This is followed by pupil dilatation with specific drops.. Patient will have blurred vision for 4-5 hours after the eye drop instillation.

Detailed check up by Retina specialist

Consultation will happen with diabetic eye specialist, who does meticulous eye examination of the cornea surface, cataract (diabetic cataracts are mainly epinuclear, cortical, PSC cataract, which can have sticky stubborn nature and requires appropriate planning preoperatively).

A detailed fundus examination with 78D lens and indirect ophthalmoscope(funduscopy) is done to meticulously examine the retina for diabetic macular edema and small tiny Neovascular blood vessels (NVE) which can lead to sudden bleeding and loss of vision if not detected and treated in early stage. Meticulous optic nerve head examination to look for glaucoma (glaucoma is a blinding preventable disease seen more commonly in diabetic patients)

The patient is categorized into either diagnosis of proliferative diabetic retinopathy(PDR), non proliferative diabetic retinopathy(NPDR) or no evidence of diabetic retinopathy. Patient may be asked to do various eye related investigations in case necessary.

All investigations under one roof

All the investigation A-Z are available under one roof at Asian eye hospital including zeiss optical coherence tomography(OCT)/ Zeiss fundus fluorescein angiography (FFA) fundus camera , Zeiss Humphreys visual field test, Pentacam, Iol master. This makes it very convenient for the patient.

Diabetic Cataract Management

In case an eye surgery is required then patient goes through detailed counselling where the patient is educated about the surgery, pre and post operative eye care, and all the small and big queries are answered to the patients satisfaction.Specific intraocular lenses are advised to diabetic patients depending on various factors.(multifocal IOL are avoided with DR , hydrophilic IOL are also best avoided in any diabetic patients)

Pre – operative consideration for diabetic Patients

We also have a diabetes (blood sugar) control team in the same premises which ensures blood sugar control of patients prior to surgery only through diet and lifestyle planning. On the day of surgery patient is asked to come fasting and a diabetic breakfast is served at our hospital to avoid any sugar hike on the day of surgery.

Intra – operative consideration for diabetic Patients

Asian eye hospital is equipped with state of the art modular operation theatre with HEPA filter, maintaining highest standards of sterile precautions. Sterile precautions during surgery in any diabetic patients becomes very important as these patients are more prone to infections. Infection rate is also controlled through micro incision cataract surgery at Asian eye hospital.

Treatment of Diabetic Retinopathy

Coming to the treatment of diabetic retinopathy I believe a holistic approach is necessary where the root cause of problem is tackled sincerely.; which is mainly long term uncontrolled sugar levels in the past, high blood pressure, anemia, raised CRP is also catered along with eye problem. The treatment of diabetic retinopathy is in the form of intravitreal anti vegf or ozurdex injections to reduce the retinal swelling in diabetic macular edema and Retinal green laser to prevent complications like bleeding within the eye (vitreous hemorrhage) or tractional retina detachment.

In addition to this, strict monitoring of other systemic problem like raised blood pressure, anemia (low hemoglobin), hypercholesterolemia, raised C reactive protein, glycosylated hemoglobin(HbA1c) is done.

In addition to this, strict monitoring of other systemic problem like raised blood pressure, anemia (low hemoglobin), hypercholesterolemia, raised C reactive protein, glycosylated hemoglobin(HbA1c) is done.

The aim of SDEC is to cater to all the above issues through a dedicated team under the guidance of Dr. Shrutika Kankariya.