By Chong Wee Hou, Optometrist, International Eye Cataract Retina Centre, Singapore

Diabetes is now reaching epidemic proportions in many countries around the world. In Singapore, the prevalence of diabetes has been steadily increasing over the past few years. It is estimated that a million Singapore residents will have diabetes by 2050. Diabetes often affects working adults and hence causes significant socioeconomic impact on these patients.

Dr Ajeet Madhav Wagle, Medical Director and Senior Consultant Ophthalmologist at International Eye Cataract Retina Centre in Mount Elizabeth Medical Centre and Farrer Park Medical Centre, was invited to give a talk to pharmacists from Guardian at HDB Auditorium on 1 August 2018. His lecture, titled “Advances in the Understanding and Management of Diabetic Retinopathy”, focused on the leading cause of blindness in working adults.

About one in three diabetics have diabetic eye disease. Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. Diabetics are at risk of diabetic retinopathy (DR), cataract and glaucoma. DR is the most common diabetic eye disease and a leading cause of blindness in working adults. Among those with DR, one in three individuals have sight-threatening or potentially blinding eye disease.

As the majority of patients with DR do not have any symptoms in the earlier stages of the disease, regular annual eye screening with retinal examination or photography is recommended for all diabetics in order to detect the disease early. All diabetics should have an annual eye examination even when they have no visual or eye complaints.

Risk factors for DR include factors such as duration of diabetes, control of blood glucose level, control of other associated conditions (eg, high blood pressure, high serum cholesterol, obesity, kidney disease) and pregnancy.

There have been significant advances in the understanding of DR and its management over the past decade. Special drugs such as anti-vascular endothelial growth factor (anti-VEGF) agents and sustained-release steroid implant are placed in the back of the eye to control leakage from diseased retinal blood vessels. Traditional retinal laser surgery has largely given way to intravitreal anti-VEGF therapy but continues to have a role in certain special situations. Advanced stages of the disease may require complex vitreoretinal surgery.

Early diagnosis and prompt treatment of DR can help preserve sight and reduce the socioeconomic impact of diabetes on the population.