Diabetic retinopathy: the leading cause of blindness and low vision in the productive age in Portugal
In about 90% of cases the severe vision loss and blindness associated with diabetic retinopathy can be prevented with very significant gains for the patients themselves and for society.
More than one million Portuguese aged between 20 and 79 have diabetes. Of these about 300,000 have diabetic retinopathy. Diabetic retinopathy (DR) is the leading cause of blindness in working age in Western countries, including Portugal. It is also the most frequently identified complication of diabetes and the one that patients fear the most, precisely because it can cause blindness. But, strange as it may seem, approximately half of the diagnosed diabetics have never seen an ophthalmologist or been to a screening program. So it's not surprising that there are approximately 30,000 diabetics with severe vision loss or blindness in Portugal due to diabetic retinopathy.
The question is: and could this severe vision loss and blindness have been prevented? We know that they could. In fact, severe vision loss and blindness associated with diabetic retinopathy can be prevented in about 90% of the cases, provided there is timely prevention and treatment of the eye disease.
The role of the patient is fundamental. Making diabetic patients aware of the imperative need to prevent and treat a disease that does not cause pain or even tearing but can lead to silent and irreversible blindness is fundamental. Good metabolic control, control of blood pressure, cholesterol, an appropriate diet and daily physical activity are fundamental to avoid serious diabetic retinopathy lesions. And the annual control of the evolution of the disease at ocular level is very important. And how can this control be done?
Through screening centered on the family doctor in conjunction with the Ophthalmology services. Only the cases not evaluated in the screening need to be observed by the ophthalmologist. Waiting for the appearance of symptoms to seek an evaluation by the screening program or by the ophthalmologist is a serious mistake that can have serious consequences.
Adequate and timely treatment can prevent the often dramatic consequences of the disease. It is a fact that we now have the therapeutic weapons to recover lost vision in most cases. But it's also a fact that a patient who comes to treatment too late and with severe vision loss has much less chance of regaining vision that allows him or her to read or drive, for example. Diabetic retinopathy, like the diabetes that causes it, is a chronic disease. That's why maintaining the treatment for as long as necessary and with the appropriate frequency is fundamental.
We cannot forget that we are in the presence of a population, the vast majority of whom are of productive age, who are unable to work. We must also remember that in about 90% of the cases, the severe vision loss and blindness that are the basis of this disability can be avoided, with very significant gains for the patients themselves and for society.
Source: "Observador.pt", November 2022