The world is facing a silent diabetes epidemic that kills approximately 4.2 million people worldwide each year. Globally, about 530 million adults have the disease and are at risk of blindness, kidney failure, heart attack, stroke and lower limb amputations that can lead to complications from the disease.
India bears the burden of more than 70 million people with diabetes, the second largest in the world. While we know diabetes, or diabetes, affects all parts of the body, chronic diseases can also damage our eyes and lead to a condition called diabetic retinopathy, which can lead to irreversible deterioration of vision. This complication of diabetes is caused by elevated sugar levels that cause retinal damage. Diabetic retinopathy is prevalent in about 17% of Indian patients with diabetes. If left untreated, this can lead to permanent blindness, increasing the socioeconomic burden in the country.
Early detection is key to managing any disease, and so is preventing permanent vision loss from diabetic retinopathy. Research shows that India has a high prevalence of sight-threatening diabetic retinopathy (VTDR), with 4% of people with diabetes over the age of 40, and an estimated 3 million people with diabetes are at risk of blindness. These figures clearly demonstrate the urgent need to spread awareness of diabetic retinopathy and to implement effective screening and management across the country.
Today, innovations in medical technology have advanced in the use of artificial intelligence algorithms to identify diabetes risk and the use of flash glucose monitors for early detection. One of the key inventions that aided in the early diagnosis of diabetic retinopathy was the development of a non-mydriatic fundus camera.
A non-mydriatic fundus camera (NMFC) captures high-resolution images of the retina. Using this technology to identify patients with diabetic retinopathy in a timely manner can help in early initiation of disease management and treatment and prevention of permanent vision loss. If any retinopathy is detected, the patient can be referred to a retinal specialist and vision loss can be avoided. Once put into use, this technology will have a positive impact on the eye care sector in India.
In addition, the NMFC has captured a wealth of data that is critical in driving further research into the treatment of diabetic retinopathy. This helps ophthalmologists monitor the progression of the disease and the effects of treatment using the technology.
Standard eye exams include dilation of the pupils with eye drops. There are a few minor drawbacks to this process, the drops take 10-20 minutes to take effect, blurring the patient’s vision and making the patient sensitive to light for hours after dilation. NMFC overcomes these shortcomings by capturing retinal images without pharmacological pupil dilation. This helps patients see their retinal condition and become aware of it immediately for quick referral to a specialist who can immediately identify and initiate necessary treatment if needed.
As such, the NMFC is a successful example of how technology and innovation can help solve a major health challenge called diabetic retinopathy. Public and private healthcare should take the initiative and adopt the technology at scale. This is being adopted as a protocol by several eye hospitals. An NMFC report should be included in every eye exam in adults, especially those with diabetes who must be screened for diabetic retinopathy at least once a year.
Such technologies are being introduced in healthcare settings, from primary care centers to community-based screening, and from opportunistic screening typically performed in clinics, pharmacies, or medical laboratories to hospitals. As many people with diabetes are asymptomatic, the detection of diabetic retinopathy can also lead to a diagnosis of diabetes and contribute to the vision of a diabetes-free India.
The views expressed above are the author’s own.
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