Representational Image. Blurring of vision, sudden blackouts are some of the warning signs of diabetic retinopathy ( Image Source: Getty )
If you are a diabetic, managing blood sugar levels is not your only priority. A growing threat of it is diabetic retinopathy, which has put nearly 3 million people in India above 40 years of age at risk of blindness, according to a study in The Lancet. What complicates the matter is that symptoms are hard to spot in the early stages and thus, a comprehensive eye test every year for diabetic patients above 35 years of age is necessary, said Dr Sundaram Natarajan, a crusader against diabetic retinopathy in India for the past 25 years.
In a freewheeling interview to ABP Live, Dr Natarajan, who was conferred with the Padma Shri in 2013 and is the president of the International Society of Ocular Trauma, shed light on the perils of diabetic retinopathy in India, how it can be diagnosed using just a smartphone, and his dream to have every Indian screened for the ailment.
Diabetic retinopathy, which damages blood vessels in the retina, a layer of tissue at the back of the eye that senses light and sends signals to the brain enabling a person to see, is the major cause of blindness in India, Dr Natarajan said. According to him, India has 100 million diabetics but around 58 million do not know they have diabetes and that it is a sight threat.
The most concerning part of diabetic retinopathy is if you wait for symptoms to appear, then it is already too late. That’s why every Indian should be screened for diabetes and diabetic retinopathy after the age of 35. Health officers at every municipal corporation and also at panchayat-level should conduct Hb1AC test for adults above age of 35, said Dr Natarajan, considered an authority in vitreo retinal surgery.
Blurring of vision, sudden blackouts, and flashes of light are some of the warning signs of diabetic retinopathy.
While screening for retinopathy has been conventionally done through fundus photography using cameras that may cost up to Rs 50 lakh, Dr Natarajan said it can now be diagnosed at home using a smartphone, making it an affordable and efficient option.
A Bengaluru-based firm has come up with an infrared camera that can be attached to any smartphone to take the image of the retina. The image then has to be uploaded to an offline AI-based software that will help detect retinopathy.
Dr Natarajan, who was involved in a study on diabetic patients at Municipal Corporation of Greater Mumbai dispensaries, said the smartphone-based retinal imaging software showed promise. The study, published in the Journal of the American Medical Association (JAMA), found the algorithm showed 100 percent sensitivity and 88.4 percent specificity in detecting referable diabetic retinopathy (RDR).
India has a ratio of only one ophthalmologist per 100,000 people. The use of AI will enable screening for diabetic retinopathy in remote areas where the services of an ophthalmologist are scarce, he said.
Since 2017, Dr Natarjan has been holding two camps per day at Municipal Corporation of Greater Mumbai dispensaries to screen diabetes patients for retinopathy besides training community health workers on how to check for the ailment using smartphones.
According to Dr Natarajan, India has the best treatment available for diabetic retinopathy than anywhere in the world, and the country is a pioneer in 3D surgery.
In the initial stages, laser therapy is done to seal blood vessels. Those with moderate symptoms are given intravitreal injections called anti-VEGF (vascular endothelial growth factor) inhibitors to aid the growth of new blood vessels and improve vision. In case of hemorrhage or retinal detachment, surgery is the last option, which may cost up to Rs 2 lakh, Dr Natarajan said.
The ophthalmologist, who once held the Guinness World Record for the most diabetic eye screenings (649) in eight hours, is currently doing research on treating retinopathy using curcumin (haldi) under the government’s National Biopharma Mission.
I am working to infuse chemical technology in the treatment of diabetic retinopathy. My idea is to use the chemical content of curcumin. Curcumin does not get absorbed in the body when you take it with vegetables or rasam. But, the same curcumin can be beneficial if injected into the eye. Presently, clinical trials are going on, he said.
