World Sight Day: Diabetics need to take care of eyes

NST: KUALA LUMPUR: When Osmah Saad was driving home from work one day, her vision suddenly blurred. Within minutes, she was nearly blind.
Although Osmah, a diabetic, had been struggling with poor eyesight for nearly two months, she did not expect to lose her sight completely.
"No one told me my eyesight would go because I’m a diabetic. Even before the incident, I was having problems when I used the computer or taught my students," said Osmah, who lectures at the Sultan Abdul Halim Teaching Institute in Alor Star.
Osmah, 57, had been suffering from cataracts since she was 46 years old. She had been on diabetic medication for three years but instead of taking her prescriptions, she turned to herbal products.
"The medicine the doctor gave me made me tired so I took mangosteen shoots and my strength returned," she said when met at Hospital Universiti Kebangsaan Malaysia where she was due for a vitrectomy surgery to remove a blood clot from the eye.
While her strength may have returned, her eyesight has worsened because she did not take her prescribed medications.
"If only you had taken your medication properly, your eye problem would have been better controlled," HUKM consultant ophthalmologist Professor Dr Muhaya Mohamad told her, adding that it was rare to get cataracts at the age of 46.
Dr Muhaya’s frustrations are understandable as there is a lack of awareness among diabetics that they are 25 times more likely to become blind than non-diabetics.
"This means that more people are going to lose their eyesight because they are not aware of the link," she said.
Currently, there are 3.5 million diabetics in the country. Every year, 10,000 become blind.
In an interview in conjunction with World Sight Day today, Dr Muhaya, who is the chairman of the Ophthalmological Society of the Malaysian Medical Association (OSMMA), said diabetic retinopathy and other retinal problems, including blindness, were growing problems which were set to become worse as the country was on the brink of a diabetes epidemic.
Diabetic retinopathy is an eye disease that can cause decreased vision and blindness. Depending on a patient’s condition, diabetic retinopathy can progress quickly or slowly. Factors that may hasten the progress include heavy smoking and poorly controlled hypertension, diabetes and hyperlipidemia (high cholesterol).
Diabetic retinopathy occurs when the eye vessel leaks and the retina becomes ischaemic, or half-dead. Since the retina lacks oxygen, it produces a substance which induces the formation of new blood vessels which are abnormal.
These abnormal blood vessels can bleed suddenly and lead to immediate blindness.
"It is not easy to reverse this as it requires major surgery. However, people usually come to us too late," Dr Muhaya said.
In 1999, a study on insulin-dependent diabetics showed that 10 per cent suffered from diabetic retinopathy. The figure rose to 43 per cent a few years later.
Dr Muhaya said it was frustrating that diabetics were becoming blind in their productive years. This could be avoided if people managed their lives better, she said.
"The roti canai, teh tarik, rice and nasi lemak are our staple diet but these are such damaging food.
"There was a patient in his 30s who used to skip lunch and have a carbonated drink instead. Five years later, he developed diabetes. His kidney is now failing and he is blind in one eye."
The problem is compounded when doctors fail to send diabetic patients for eye tests.
Such was the case of former vegetable seller Lee Yoke Kien, 66.
"I have been a diabetic for 20 years but in the early days, the doctor did not tell me that it could lead to blindness," he said.
He was finally referred to HUKM by a different doctor five years ago for a cataract surgery.
Dr Muhaya said doctors should refer all diabetic patients to an ophthalmologist at the time of diagnosis. They should also ensure that diabetic patients have a yearly follow-up.
Even if a diabetic’s vision is not affected, they should still go for regular eye check-ups.
Among the treatment options is laser therapy which is done as outpatient treatment. It is a painless and effective way of correcting eyesight.
In conjunction with World Sight Day, the OSMMA’s Eye Fund and the Association of Wives of Petronas Officers and Petronas Lady Officers will be putting up 100,000 posters on diabetic blindness at Petronas stations around the country in three languages — English, Bahasa Malaysia and Tamil.