Diabetic retinopathy usually starts as a minor complication of diabetes mellitus. But it soon starts to attain a separate identity and manifests into a disease that has its own identity. Diabetic retinopathy is capable of leading to blindness if not managed properly. Patients need to understand that after a certain level, even if the diabetes is under control, diabetic retinopathy may progress in its own terms. Hence, once the symptoms of diabetic retinopathy are identified for the first time, the condition should be handled with extreme care.
At Matha Ayurveda Eye Hospital, a unique and successful protocol for management of diabetic retinopathy has been developed. These ayurvedic treatment for eyes are aimed to protect and preserve the vision of patients effected with diabetic retinopathy.
The primary challenge in treatment of diabetic retinopathy is that the starting stage of this condition is missed in most cases. The reason for this is that vision is not affected considerably during the initial stage. Also, the patient will only be thinking about controlling about the blood sugar level and vision changes do not cross the mind of a diabetic patient.
Many diabetic patients fail to comprehend the fact that even if the blood sugar is within normal limits, diabetic patients have chances of developing diabetic retinopathy. The factors that affect the development of diabetic retinopathy are:
- Severity of diabetes mellitus
- Chronicity of diabetes
- Hereditary nature of diabetes in the family of the patient
- Body constitution – Dosha prakrithi (According to ayurvedic science) of the patient
- Environmental factors where the patient resides
- Occupational factors of the patient
- Stress and strain endurance levels of the patient
- Dietary factors of the patient
- Habitual factors of the patient
It becomes the duty of all physicians, especially diabetologist to direct diabetic patients for consultation with an ophthalmologist, even if the patient does not presently complain about vision problems. The initial symptoms of diabetic retinopathy can be summarized as follows :
- Mild headache
- Eyes strain during reading, computer monitors, TV screens etc
- The fullness of the head especially during the early morning
- The heaviness of the head especially during the early morning
- Hypersensitivity to bright light
- Watering of the eyes especially while straining
Once the disease manifests, its further development will depend on various factors which have been described before. It will vary from person to person also. Simultaneously, pathological changes can also be seen as described below:
- Dilation of vessels of the eye
- Congestion in retinal vessels
- Blockages in the microvascular system of the retina
- Edema in the retina
- Formation of exudates
In further advanced stages, the condition will manifest into the following stages which are highly dangerous:
- Macular hole
- Retinal detachment
- Permanent degenerative changes in the vision
According to ayurvedic theory, the progress of diabetic retinopathy is classified into three distinct stages which are described below:
- The Primary stage – This stage is termed as the stage of Kapha Predominance. An ayurvedic science, it is called Netrabhyshyandha. Patients do not experience any considerable visual problems during this stage. Only experienced ophthalmologists would be able to identify the onset of diabetic retinopathy during this stage. Treatment procedures done during this stage are Sira Sodharanam, Nasyam, Kabalam and Gandoosham. These procedures are more preferred than ophthalmic applications during this stage of diabetic retinopathy
The secondary Stage – This stage is termed as the stage of pitta predominance – When the condition of diabetic retinopathy progresses to this stage, the patient would have experienced considerable visual problems and reach either an eye specialist or an ophthalmologist. Patient experience the following symptoms during this stage
- Vision Blurring
- Sudden decrease in vision
- Burning sensation in the eye
Coming to the treatment aspects in this stage of diabetic retinopathy, it needs to be noted that ere, pitta is the predominant dosha. Hence, Pitta samana chikitsa is the preferred line of treatment. Treatment procedures preferred are Shirodhara, Netra sekam, purambada , Aschotanam and thalam. Patients also need to follow strict dietary and habitual schedules. During this stage, medications alone would not be sufficient. Even minor habits such as head bath, sleep, journey, oil application, need to be scheduled along with medicine and the schedule followed. These factors vary from person to person depending on the clinical stage of the disease. If treated correctly according to ayurvedic science, further complications and vision loss can be arrested at this stage
- The Tertiary Stage – This stage of diabetic retinopathy is referred to as the stage of Tridosha predominance. It is also called as the stage of complications. If the secondary stage is not correctly handled, and the etiological factors continue, the condition progresses to this tertiary stage. Here, a strict line of treatment cannot be conveyed. It depends on the particular complication that has manifested for the patient. For example, if the complication is retinal detachment, vata predominant treatments are done. However, if there is neo-vascularization, pitta is considered more. If there is fluid accumulation, kapha is taken seriously according to ayurvedic science.
The ayurvedic treatment of diabetic retinopathy starts with the correct identification of the clinical stage of the disease as described above. At Matha Ayureda Eye Hospital, this is achieved by a three stage process. At first, patients undergo a detailed initial assessment. After the initial assessment, the required diagnostics are conducted by the doctors. Then patients meet with senior physician / Chief Physician, where is diagnosis is confirmed and a care plan is charted out. The care plan contains the duration of treatments, treatments proposed, medicines, duration and expected results. Patients are explained about the care plan in detail.