On 21 Jun, 2025, Seniors Today hosted their weekly Health Live Webinar with a Senior Ophthamologist, Dr. Savita Bhat who spoke on and answered questions about Diabetic Retinopathy.
About Dr Savita Bhat
Dr Savita Bhat is a Senior Consultant in Glaucoma, Cataract and Medical Retina at the Chellaram Hospitals, Diabetes Care and Multispeciality, Pune.
She completed her MS (Ophthalmology) from Christian Medical College, Vellore and worked as a Consultant at the Giridhar Eye Institute after her Medical Retina Fellowship.
She has published extensively in the field of Glaucoma, with several publications in leading journals, including the American Journal of Ophthalmology and the Journal of Glaucoma (USA) and Retina. She has contributed articles on diabetes in books.
She has won best research paper awards at the national and state levels on five occasions, including the Best Neuro-ophthalmology Research Paper at the national level in January 2000, and the prestigious Siva Reddy Research Award in the year 2009.
Dr Bhat regularly takes part in lectures, instruction courses and workshops at both regional and national levels. Her paper was accepted for presentation in Asia Pacific Association of ophthalmology, Guangzhou 2015.She has participated in World Glaucoma Congress 2021 and Asia Pacific Glaucoma Congress 2021
Dr Savita Bhat has also participated in multinational clinical trials in ophthalmology. She has also participated in several multinational clinical trials in glaucoma.
The eye appears to as the upper lid, lower lid and a bluish/ black/ brown structure which imparts the colour to your eye, the iris. The central black portion, is the window that lets light enter the eye and helps us see the different structures that we see, the lens.
The eye appears like a round ball and functions like a camera.
The retina is a structure that takes over an entire surface area.
The different structures of the eye include:
- Cornea: this is a transparent structure that is present over the iris.
- Lens: this is crystalline, it can get foggy and cause cataract
- Retina: covers an entire surface area.
Your vision can be normal, but the retina can get retinopathy at the back at various stages, causing retinopathy.
In diabetic retinopathy, the small blood vessels and nerves inside the eye get affected and cause leakages. Depending on what stage of retinopathy you are at, you are called for review, screening and if required, a treatment.
A normal retina has a central black portion, this is the portion where you get perfect images. The optic nerve connects the eye to the brain and tells you what you’re viewing. The retinal blood vessels can also be seen, you can visualise whether they are normal/ leaking/ clogged/ normally functional.
An angiography can also be done for the retinal blood vessels by injecting dyes. This helps us see the type and stage of retinopathy and the type of therapy that you require.
Diabetic retinopathy can be classified into 2 groups:
- Non proliferative diabetic retinopathy: this is less sinister
- Diabetic retinopathy: the original blood vessels are completely destroyed and they are replaced by either fluid or blood, making the retinal hypoxic (asking for more nutrition). At this stage, the body tires to repair itself by making new blood vessels.the new blood vessels are not strong, they usually bleed or burst and this stage is called proliferative diabetic retinopathy.
Diabetes can cause cataract, glaucoma and diabetic retinopathy.
To visualise the retina and check for signs of diabetic retinopathy, the eye needs to be dilated.
A preliminary examination can be dome with the help of hand held scopes
The non proliferative type of diabetic retinopathy appears as small balloon like structures of the retinal blood vessels. It can cause leakage around the complex structures of the retina, it can also cause oedema leading to blurring of vision to hazy vision.
The most important complication is when the leakages are farther apart, covering a wider surface area of the retina. If it involves the fovea, it can cause- leakage, macular oedema, fluid collection in the retina- resulting in significant diminution in vision. This is seen at an advanced stage in diabetes and can be treated with painless injections.
The hallmark of proliferative type of diabetic retinopathy is formation of new blood vessels which are weak and fragile. These are treated with laser and injections.
If it worsens further, the retina can get pulled and damaged and restful in further detachment of the retina. This requires more severe form of treatment.
Stages of retinopathy:
- Blotchy red spots in retina. This is seen with non proliferative diabetic retinopathy
- The blood vessels can also have cholesterol like substances- this is the moderate stage
- Severe
- Very severe non proliferative diabetic retinopathy
One should not wait till the advancement of the disease. However, sadly, the initial stages of retinopathy are usually asymptomatic. This is why diabetic patients are advised to get regular eye check up in addition to their blood sugar levels.
Investigations and examinations done include:
- Angiography of retinal blood vessels
- Optical coherence tomography (OCT)
It is treated with laser and photocoagulation of the vessels.
Your control of blood sugar is very important to prevent complications such as retinopathy.
