Page 67 - NAME OF CONDITION: REFRACTIVE ERRORS

NAME OF CONDITION: DIABETIC RETINOPATHY

I. When to suspect/ recognize?

a) Introduction:

Diabetes Mellitus (DM) has established itself as a pandemic disease, projected to
affect 438 million people by 2030 AD.. The exponential growth in the incidence and
identification of systemic diabetes has projected diabetic retinopathy as one of the
leading causes of visual loss globally.

Diabetic retinopathy (DR) is one of the most frequent causes of blindness world-
th
wide. In India DR which was the 17 cause of blindness but has now ascended to the
th
6 position. Diabetic retinopathy screening is directed towards improving health
care services for persons with diabetes and diabetic retinopathy. It is symptomless in
its early stage; screening is the only way to identify these patients to prevent them
from going blind. The number of DR patients’ increase with increase in the diabetic
population, especially in developing countries where there is resource scarcity.
Timely treatment can prevent vision loss which means that all of the diabetics have
to be regularly examined for DR.

b) Case definition:
Diabetic Retinopathy is primarily a microvascular disease. For all practical purpose
fundus changes like micro aneurysms, hard exudates and hemorrhages in diabetic
patients are to be considered as diabetic retinopathy until proved otherwise. The
most common cause of visual loss in diabetic patients is due to macular edema
(DME) and advanced diabetic retinopathy (Vitreous hemorrhage and Retinal
detachment).

II. Incidence of the condition in our country
Diabetic retinopathy is the leading cause of blindness among adults in the
developing countries and is emerging as an important cause of blindness in the

developing countries next to cataract. The longer the duration of diabetes higher is
the incidence of developing diabetic retinopathy. In India, there is a paucity of data
on the prevalence of DR in type 1 diabetes mellitus, as a registry for prevalence of
type 1 diabetes is only recently being set up in the country. The prevalence of
diabetic retinopathy in India, according to various population based studies is in
between 17.6% to 34.1%. An earlier study done in a clinic-based population reported
an overall prevalence of 14 per cent of DR in a diabetic population examination. Of
these, non proliferative diabetic retinopathy (NPDR) accounted for 6 per cent,

macular oedema accounted for 4 per cent and proliferative diabetic retinopathy
accounted for rest of the 4 per cent.
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