Recently a seminar on diabetic retinopathy was held in hotel Nirmala under the auspices of the All Manipur Opthalmological Society. The speakers were Dr K.Romen (Shija Hospital), Dr Th Premchand(RIMS), Dr Deependra Bikram Singh (Delhi) and Dr Gyanendra Singh (Rajasthan).Different aspects of the topic were discussed by the different speakers. Dr Deependra discussed about the newer methods of investigation for retinal problems. Incidently it may be mentioned here that the retina is the innermost of the three layers of the retina and the major brunt of the attack of diabetes falls on the retina and can lead to blindness. Timely treatment leads to prevention of this blindness. Retina is the layer of the eye which forms the images of all that we see.

According to the study done by Dr Premchand’s group at RIMS hospital the prevalence i.e. the percentage of people suffering from diabetes in Imphal is a little over 6%.This study was done about a decade ago and the overall impression of the panellists was that today it could be even higher and could be around 8%.Diabetes broadly speaking is divided into two categories-type 1 which occurs in the younger age groups and requires insulin for treatment and type 2 which occurs more in the adult or elderly population. Type 2 diabetes is 15 to 20 times more common than type 1 diabetes. In type 1 diabetes usually significant retinopathy i.e. damage to the retina does not occur in the first 5 years after the onset of diabetes while in the type 2 retinopathy can occur right at the onset of the illness. Over a period of 20 years almost all type 1 diabetics and upto 60 to 80 % of type 2 diabetics can have retinopathy. The incidence of blindness is 25 times than that of non diabetics. American statistics shows that around 18 million of Americans have diabetes and strangely enough half of them are not even aware that they have the disease. In India if the incidence is accepted to be 6%, then at least 60 million people have diabetes. Presuming the population of Imphal to be around 7 lakhs, about 42,000 diabetics are there in Imphal alone.

Diabetic retinopathy is divided into non proliferative (which is much less dangerous) and proliferative (which is dangerous and can cause blindness).There is another condition know as macular edema which is seen more commonly with non proliferative retinopathy, but is as dangerous as the proliferative condition as it can cause blindness. American statistics shows that about 7 lakh Americans have proliferative retinopathy and every year about 65,000 new cases develop. About 5 lakh people in America suffer from macular edema and every year 75,000 new cases develop this problem. Translating this to Indian figures about 2 and half million cases of proliferative retinopathy exists in India and about 1.5 to 2 million cases of macular edema exist in India.

To prevent retinopathy the best method is to control blood sugar very well. This markedly reduces the chances of retinopathy and good control of blood pressure also reduces the development of retinopathy. Once retinopathy develops the best method of treatment is Laser treatment. Dr Romen who has been trained specially in retinal diseases has a special expertise in Laser therapy and surgery of the retina, talked extensively on the treatment of proliferative retinopathy and macular edema, quoting some of the most important research work which has been done internationally in this particular field. Incidentally it may be mentioned here that at present Shija Hospital and Research Institute has the only installed Retinal laser therapy instrument (imported from America) in the state of Manipur.

The recommendations of the experts at the seminar was that every type 2 diabetic should have a eye check up by an Opthalmologist once every year right from the time he/she is diagnosed to have diabetes. In case a patient develops proliferative retinopathy or macular edema the follow up with the ophthalmologist has to be much more frequent- weekly to every 2 or 3 monthly depending on the severity of the case. Treatment should be begun before significant damage is done to the eye because if the eye is irreversibly damaged then treatment outcome is not good. Timely treatment leads to prevention of blindness in 50 % of the cases.