💋 Patient Guide — Eye Condition ஀யறியின் கல்வி — நீரி୶ிவு கண்

Diabetic Eye Disease

நீரி୶ிவு கண் நோய்

Diabetic retinopathy stages, investigations, precautions, and follow-up schedule — protect your vision.

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Patient Guide

Diabetic Eye Disease

Diabetic Retinopathy · Diabetic Macular Oedema · Cataract · Glaucoma
Stages of Diabetic Retinopathy Stage 0 No DR Annual screen 🟢 → Mild NPDR Stage 1 Micro- aneurysms 🟡 → Moderate NPDR Stage 2 Haemorrhages exudates 🟨 → Proliferative PDR Stage 3 New vessels PRP Laser! 🔴 → DMO Stage 4 Macular fluid+Injections 🟥 Progression can be silent — regular screening is essential

Stages of diabetic retinopathy

Screening Schedule
Type 1 DM: 5 yrs after diagnosis, then annual
Type 2 DM: At diagnosis, then annual
If DR present: Every 3–6 months
Pregnancy & DM: Each trimester
If PDR / DMO: Monthly
How Diabetes Damages the Eyes — Silently நீரிழிவு கண்ணை அமைதியாக எப்படி பாதிக்கும்?
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High blood sugar over years causes progressive damage to the small blood vessels supplying the retina. This process is called diabetic retinopathy (DR) — the leading cause of preventable blindness in working-age adults worldwide.

The critical danger: diabetic retinopathy causes no symptoms in its early stages. By the time the patient notices blurred or distorted vision, significant irreversible damage has often already occurred. This is why regular screening is so important even when vision feels normal.

How the damage occurs

  1. High glucose damages the walls of retinal capillaries (tiny blood vessels)
  2. Vessel walls weaken — they bulge (microaneurysms) and leak fluid and lipids
  3. Leaking causes oedema (swelling) in the retina
  4. Oxygen deprivation signals the eye to grow new, fragile blood vessels (neovascularisation)
  5. These new vessels bleed easily, causing vitreous haemorrhage and traction retinal detachment

Warning: Diabetic retinopathy can progress silently to an advanced stage while vision feels completely normal. All diabetics must have annual dilated eye examinations regardless of how good their vision is.

Stages of Diabetic Retinopathy நீரிழிவு விழித்திரை நோயின் நிலைகள்
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🟢
No DR
No visible retinal changes. Annual screening. Focus on glucose control.
🟡
Mild NPDR
Microaneurysms only. Annual review. Strict HbA1c <7%.
🟨
Moderate NPDR
Haemorrhages & exudates. Review every 3–6 months. Tighter control.
🔴
Severe NPDR
Extensive lesions, cotton wool spots, venous beading. Risk of progression high. Consider PRP.
🟥
PDR
New vessels! PRP laser urgently needed. High risk of vitreous bleed & detachment.
🔵
DMO
Macular fluid at any DR stage. Anti-VEGF injections or laser. OCT monitoring.
Essential Investigations for Diabetic Eye Disease நீரிழிவு கண் நோய்க்கு அவசிய பரிசோதனைகள்
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InvestigationWhat it showsWhen needed
Dilated Fundus ExamDirect view of retina, vessels, optic discEvery visit
OCT (Macula)Cross-section of macular layers — detects fluid (DMO)Every visit if DMO known or suspected
Fundus PhotographyDocument baseline and monitor progressionAnnually, or when DR present
FFA (Fluorescein Angiography)Leaking vessels, ischaemia, neovascularisationBefore laser/injection or to map disease
Visual Field (Perimetry)Peripheral vision defects, concomitant glaucomaIf optic nerve involvement suspected
TonometryIOP — neovascular glaucoma risk in PDREvery visit

Blood tests required: HbA1c, fasting glucose, lipid profile, kidney function (eGFR/creatinine), and BP monitoring are all important — systemic control directly influences the rate of DR progression.

Precautions, Lifestyle & Daily Protection முன்னெச்சரிக்கைகள், வாழ்க்கை முறை மற்றும் அன்றாட பாதுகாப்பு
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✓ Do

  • Keep HbA1c < 7% — this is the single most powerful way to prevent DR
  • Control blood pressure below 130/80 mmHg
  • Control cholesterol — statins reduce hard exudate formation
  • Have annual dilated eye exam even if vision is normal
  • Have eye exam immediately if vision changes
  • Exercise regularly — improves glucose control
  • Eat a diet low in refined sugar and saturated fats
  • Report new floaters, flashes, or vision loss immediately

✗ Avoid

  • Smoking — accelerates vascular damage significantly
  • Skipping medications (antidiabetics, antihypertensives)
  • Self-adjusting insulin or oral agents without medical advice
  • Ignoring symptoms ("my vision is fine, I don't need a check")
  • Delaying treatment — DR worsens faster than most realise
  • High-salt diet (raises BP)
  • Alcohol in excess
Follow-up Schedule for Diabetic Eye Disease நீரிழிவு கண் நோய் பின்தொடர் அட்டவணை
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No DR
Annual dilated retinal examination. Focus on optimising blood glucose, BP, and lipids.
Mild NPDR
Annual eye review. HbA1c target <7%. Reinforce lifestyle changes.
Moderate NPDR
Every 3–6 months. OCT if macular involvement suspected. Consider referring to retina specialist.
Severe NPDR
Every 3 months. High risk of PDR — PRP may be discussed.
PDR
Monthly. Urgent PRP laser. Anti-VEGF if vitreous bleed. Close monitoring for tractional detachment.
DMO (any stage)
Monthly OCT. Anti-VEGF injection series. Focal laser as adjunct if needed.
Pregnancy + DM
Eye exam each trimester. Pregnancy can accelerate DR significantly.

Emergency: See an ophthalmologist the same day if you notice: sudden loss of vision, a shower of black spots or floaters, a dark curtain or shadow across part of your vision, or a significant sudden change in vision.

Need a Consultation?

Book an appointment with Dr. Laavanyaa at SRM Prime Hospital or P&G Multispeciality Hospital, Chennai.

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