Hope in sight

The recent World Sight Day with the theme ‘Hope in Sight’ aims to focus global attention on vision impairment and blindness.

Diabetic retinopathy is a diabetes complication that affects the eyes. High blood sugar levels damage the blood vessels in the light-sensitive tissues of the eye (retina). Other risk factors for diabetic retinopathy include high blood pressure, high cholesterol level, and overweight/obesity.

Diabetic retinopathy is the leading cause of vision loss and preventable blindness among adults. Researchers estimated an overall prevalence of 34.6 per cent for diabetic retinopathy in people with diabetes – that is a staggering one in every three diabetics.

The burden of diabetes in Malaysia is enormous. The National Health and Morbidity Survey 2019 reported the diabetes prevalence at 18.3 per cent; in other words, almost one in every five Malaysian adults have diabetes.

However, only around 56 per cent of known diabetics had an eye examination within one year – despite our clinical guidelines’ recommendation for annual screening.

The annual eye screening is not just for the prevention of vision impairment and blindness. To the clinicians, diabetic retinopathy is a reliable marker of the harmful diabetic effects in the patients. The presence of retinopathy signals the high risk of developing other diabetic complications such as kidney complication, nerve damage, heart attack, and stroke.

The mainstay of prevention and treatment of diabetic retinopathy is by having good glycated haemoglobin A1C (reflects blood glucose control over three months), blood pressure, and LDL-cholesterol (bad cholesterol) parameters – also known as the “ABC” of diabetes.

The benefits of achieving more ABC treatment goals are incremental. The more goals achieved, the better the outcomes in preventing diabetic retinopathy and other complications such as heart disease, stroke, and death.

Yet, the proportions of patients achieving all ABC goals are under 10 per cent in many places such as Hong Kong, European countries, the United States., In Malaysia, 5.8 per cent of our diabetic patients achieve all their ABC goals.

What can people with diabetes do to prevent diabetic retinopathy? It is essential to optimise the ABC control by adhering to your doctor’s advice and treatment plan. Eat sensibly, exercise regularly, reduce bodyweights (if overweight/obese), and stop smoking will help.

Lastly, do not forget to get the annual eye examination done.

The article was written by Dr Wan Kim Sui, Professor Dr Noran Naqiah Hairi and Professor Dr Moy Foong Ming. It was first published on the Malay Mail newspaper. Dr Wan Kim Sui is a Doctor of Public Health candidate from the Ministry of Health supervised by Prof Dr Noran and Prof Dr Moy.