Dr Shobana Nadarajah, an ophthalmologist based in Petaling Jaya, shed light on two common eye diseases in Malaysia: diabetic retinopathy and cataract.

Diabetic retinopathy

“Diabetic retinopathy is a microvascular complication that occurs in the retina, which is the nerve of the eye.

“Microvascular means it affects the tiny blood vessels in the eye. The eyeball is so small, thus the blood vessels in the retina are also very fine,” said Shobana.

She said diabetic retinopathy is common in those who have uncontrolled diabetes where their sugar levels are constantly high. Uncontrolled diabetes narrows the blood vessels and impedes oxygen flow to the nerve cells.

There are four stages: mild, moderate, severe and proliferative retinopathy.

Interestingly, retinopathy in the eye might reveal if there is damage occurring in other main organs such as the heart and kidneys.

According to Shobana, the prevalence of the disease in Malaysia is about 35-45%, while the global prevalence is approximately 34%. Among the signs and symptoms of diabetic retinopathy are:

• Blurred vision.
• Floaters, which are tiny specks, worm or mosquito-like structures that appear to float before your eyes.
• Fluctuating vision – when clear vision becomes blurred and foggy for a couple of hours after a meal.
• Frequently having to change glasses due to unclear vision.

“Anyone with type 1 or type 2 diabetes is at risk of developing diabetic retinopathy,” she said, adding the longer a person lives with diabetes, the more likely they are to develop diabetic retinopathy. Pregnancy and smoking increase the risk for diabetic retinopathy.

She has also observed an increasing trend of diabetic retinopathy in younger patients. Unfortunately, people with all stages of diabetic retinopathy often have no symptoms until they are at an extremely high risk for vision loss.

As such, it is important to undergo regular diabetic retinopathy screening with a comprehensive eye examination. Early intervention, after all, is always best.

Treatment options include:

• Anti-vascular endothelial growth factor or VEGF injections.
• Retinal laser.
• Vitrectomy surgery.

When it comes to prevention steps, Shobana said: “The main thing would be to control diabetes and other factors such as high blood pressure and high cholesterol.

“Stop smoking, lead a healthy lifestyle which includes exercise and a diet without excessive carbohydrates which turns into sugar.”

Cataract

“A cataract is the clouding of the natural lens and can be due to age or an injury to the eye,” explained Shobana.

Among the signs and symptoms are cloudy vision, sensitivity to light and frequently having to change one’s glasses due to unclear vision.

Having cataracts is akin to looking through a frosty or fogged-up window, making it more difficult to read or drive a car at night.

You are at risk of developing cataracts if you are:

• Between 50 and 65, or
• Have diabetes as it can speed up the progression of a cataract, or
• Have suffered a significant injury to the eye.

Additionally, you are more prone to developing cataracts earlier if you have recurrent inflammation in the eye or if there is a chronic use of oral steroids.

Most cataracts develop slowly and don’t disturb one’s eyesight early on. However, cataracts will eventually affect vision.

At first, stronger lighting in the surrounding environment and eyeglasses can help but if impaired vision affects one’s usual activities, surgery is the only way to remove cataracts.

During surgery, an ophthalmologist removes the clouded natural lens and replaces it with an intraocular lens or IOL, an artificial lens that permanently stays in the eye.

An IOL is clear, like a natural lens, and can correct refractive errors, allowing one to rely less on glasses or contact lenses post surgery.

While cataracts cannot be prevented, time is of the essence.

“Many people come in late because they’re afraid of surgery or they think there’s no need for it. But that leads to being homebound and not being able to do what they like such as playing golf, going for walks or driving out to meet their friends. This could lead to depression or self-isolation.

“Cataract surgery now is very simple. My advice is to see a doctor and get it done, if necessary,” she said.