Diabetic retinopathy, a diabetes complication that affects the eyes is among the leading causes of preventable blindness and vision impairment according to the World Health Organization. The Action Plan for Integrated People-Centred Eye Care in South-East Asia 2022–2030 mandates that at least 80 per cent of people with diabetes should undergo regular eye examinations. However, in Bhutan, the National Health Survey 2023 shows that only half of the diabetic patients received eye examinations.
According to the National Health Survey 2023, the retired, non-working population and those residing in Thromdes who have diabetes underwent eye examination compared to the working population and those living outside Thromdes.
An ophthalmologist or eye doctor from the Gyalyum Kesang Choeden Wangchuck National Eye Centre says the gap in eye screening for diabetic patients is usually because of late follow-up saying that they live far from the healthcare centres.
Dr Phuentsho Dorji, Ophthalmologist/Retina Specialist of Gyalyum Kesang Choeden Wangchuck National Eye Centre said “They come for a follow-up, but not at the right time. So, that is the main drawback for the follow-up. Diabetic retinopathy has two different categories. We have proliferative diabetic retinopathy which is more of an advanced stage and then we have non-proliferative diabetic retinopathy which is the initial stage of diabetic retinopathy. In the case of non-proliferative diabetic retinopathy, there are different categories mild, moderate and severe. Especially in terms of follow-up for mild to moderate non-proliferative diabetic retinopathy, I usually advise them to get follow-up.”
He added that besides the national eye centre, such follow-ups are provided at the regional hospitals, and Phuentshogling and Samtse hospitals.
The eye doctor said that depending on the severity of the retinopathy, the hospital provides surgical and non-surgical treatment.
However, doctors said symptoms will not appear during the initial stages. So, they recommend all diabetic patients to come for eye screening.
According to the doctor, research from about three years ago showed that about 36 per cent of diabetic patients were found to have some form of retinopathy.
Besides diabetic retinopathy, raised blood sugar or diabetes can cause maculopathy, cataracts and glaucoma.
Dr Guru Prasad Dhakal, Head of the Department of Medicine, JDWNRH said “The retina is the place where it is light sensitive. It detects the light that comes from outside and identifies the object. If that is damaged then, that is called retinopathy. In severe retinopathy, there is another portion of the retina called the macula so if that macula is involved then it is called maculopathy. If there is the clouding of the lens it is called cataract and if there is raised blood pressure inside the eye that affects the nerve carrying the images from the eye to the brain, it is called glaucoma.”
He added that to prevent such complications, eye screening, controlling blood sugar, blood pressure and cholesterol, along with quitting tobacco is a must.
According to the National Health Survey 2023, 59.4 per cent of the population were unaware that they had diabetes.
Further, the survey showed that the prevalence of diabetes has increased to 5.8 per cent in the country.
Singye Dema
Edited by Tshering Zam
