World Retina Day is all about shining a light on the importance of eye health, specifically the retina, that tiny but mighty part at the back of your eye that makes clear vision possible. Without it, things like reading your favorite book, scrolling on your phone, or even recognizing faces would be a real struggle.We at TOI spoke to Dr. Yogesh Patil, Vitreo-Retina Surgeon, Dr Agarwals Eye Hospital, Sanpada; Dr. Kalpana R, Senior Consultant, Ophthalmology, SIMS Hospital, Chennai; Dr. Krishna Nagaradh, Vitreo – Retinal Consultant, Dr Agarwals Eye Hospital, Bengaluru on common retinal conditions and how to take care of retinal health.
What are the most common retinal conditions you see today, and are cases increasing with lifestyle changes like screen time and diabetes?Dr. Yogesh Patil: Age related vision changes are usually gradually progressive like needing reading glasses(presbyopia), scattering of light especially at night, taking longer time to adjust when going from bright to dark places, fluctuating vision. These are normal age related changes which can be treated with glasses, lubricant eye drops or better lighting. But if vision changes are sudden in onset, asymmetric or associated with flashes, floaters, distortion or field loss are warning symptoms and are usually associated with Retina diseases. In such conditions an urgent dilated retinal check-up is needed with an expert. If proven Retina disease then it needs certain tests and immediate treatment as time is extremely crucial in these problems.Dr. Krishna Nagaradh: The most common retina related conditions seen today are related to diabetes and are known as diabetic retinopathy. Yes the cases are increasing to a greater extent with a sedentary lifestyle which most of the middle-aged people are used to it nowadays. Dr. Kalpana R: The most common retinal conditions we see today are diabetic retinopathy, age related macular degenerations and Glaucoma and eye stroke. Lifestyle changes like prolonged screen time renders a person obese, enhancing diabetes. Diabetes mellitus could occur familial or secondary due to co-morbidities, bad dietary habits and sedentary lifestyle. How can people differentiate between normal age-related vision changes and potential warning signs of retinal diseases?Dr. Yogesh Patil: Prolonged near work and less outdoor time is leading to higher incidence of minus Glasses called “myopia epidemic.” In children, sustained near focus may accelerate myopia progression leading to gradual increase in glass power. Higher minus power (Myopia) increases risk of several problems like retinal tears & detachments and Myopic macular degeneration. Chronic stress and irregular sleep are risk factors for development of central serous chorioretinopathy, a retinal condition more seen in young and middle aged males. Sedentary lifestyle, obesity and low physical activity can lead to early development of diabetic, hypertension and raised cholesterol levels which secondarily leads Diabetic Retinopathy, Retinal vein occlusion like diseases.Dr. Krishna Nagaradh: The vision changes due to retinal conditions are usually sudden in onset and are more obvious like appearance of floaters in front of eyes, seeing flashes or beginning to see distorted images, at the same time vision changes related to normal ageing are usually gradual like difficulty in focusing near objects over a period of time like seen in presbyopia or gradual blurring of vision with glare like symptoms seen in cataract.Dr. Kalpana R: Normal age-related visual changes could be due to receding of reading distance (usually starts in late 30’s or early 40’s) called as presbyopia. Dry eyes causing blurred vision, cataracts causing blurred vision or effective vision. Eye fatigue is common after straining. People cannot differentiate between the normal aging of the eyes and vision disturbances due to retinal diseases unless they become severe and cause a significant amount of vision loss. Hence, regular eye check-ups are mandatory to identify and treat them at the earliest. Retinal diseases symptoms are such as seeing floaters, flashes, loss of vision, loss of central vision, and loss of peripheral vision. Individuals should be mindful that before these symptoms occur a significant amount of retina is affected beyond repair in certain conditions like diabetes, degenerative diseases, glaucoma., etc. We hear a lot about diabetic retinopathy—how big of a public health concern is it right now?Dr. Yogesh Patil: Currently India has the second-largest diabetic population in the world and Diabetic Retinopathy is the most common cause of vision loss in working-age adults worldwide. Approximately in India there are 12 million people suffering from Diabetic Retinopathy and 20% of these have variable degree of permanent vision loss. The worst part of Diabetic Retinopathy is no pain, very few subtle symptoms in early stages and by the time patients present with complaints its already advanced stage with some amount of permanent vision loss. Advanced stages of diabetic retinopathy require expensive treatments like lasers, intravitreal injections, surgery). The good news is up to 90% of vision loss from DR can be prevented with timely screening, sugar control and early treatment.Dr. Krishna Nagaradh: Diabetic retinopathy is the leading cause of blindness in the middle aged population. Globally there were 12 crore people suffering from diabetic retinopathy in 2010 and this number can reach upto 20 crores by 2030. Diabetic retinopathy has the potential to cause blindness and with increasing prevalence of diabetes worldwide makes this condition a bigger public health condition which has to to be taken seriously and people should get screened so that the patients are diagnosed early and treated to prevent major vision loss.Dr. Kalpana R: Diabetic retinopathy is of major concern in today’s world since the number of cases are increasing despite awareness. It’s a condition which affects the retinal blood vessels and in turn affects the layers of the retina at different stages causing blindness if not treated at the earliest. What role does early detection play in preventing severe vision loss from conditions like macular degeneration or retinal detachment?Dr. Yogesh Patil: Macular degeneration and retinal detachment are two separate diseases but if detected early treatment is simpler and more vision rewarding in both. In case of retinal detachment early detection involves screening for flashes and floaters, detecting peripheral Retinal degeneration/tears which can easily be treated with a quick outpatient laser via major surgery for retinal detachment. Early detection of dry macular degeneration means patients can start lifestyle changes (diet rich in antioxidants, stopping smoking, supplements in select cases) and monitoring which can slow progression of condition to more devastating disease like Wet Macular degeneration. Even in wet age related macular degeneration: If detected early, intravitreal anti-VEGF injections can preserve reading and driving vision whereas detected late (scarred macula), even the best treatment cannot restore useful central vision.Dr. Krishna Nagaradh: Early detection is crucial in treating any of the retinal conditions as we can minimise the damage caused to the retina and slow the disease progression which in turn preserves the vision. In treating retinal detachment intervention done in hours to days of time will restore maximum vision.Dr. Kalpana R: The ingemination to prevent peripheral vision loss due to retinal diseases is a regular eye check up with an ophthalmologist (not optical) and following the investigations and treatment protocols suggested by the doctor without fail. The amount of retinal cells lost in the inadvertence cannot be reverted. All the attempts are to retain the viable tissue for a prolonged period to give some amount of quality of life to the patient. Retinal detachment is realized early by the patient (which is possible by noticing loss of vision suddenly or gradually, floaters and flashes) can be treated well and there is a possibility of patients getting a good quality of vision post-surgery.How important is diet and lifestyle in protecting retinal health, and what simple habits can people adopt?Dr. Yogesh Patil: We have already discussed the role of bad lifestyle/ diet results in several retina diseases. Now let’s see what rectification should be done. In terms of diets, foods rich in antioxidants (green leafy vegetables, coloured fruits) and Omega 3 fatty acids( nuts, chia seeds, fish) should be a regular part of one’s diet. Restrict refined sugars, processed food, alcohol and tobacco / smoking, regular exercise improves blood flow, lowers risk of diabetes & hypertension. Annual/ regular eye check-ups especially in diabetic, hypertensive or highly myopic. Balanced screen use and encourages outdoor activity in children to reduce myopia progression. Stress & sleep management – lowers risk of CSCR and helps overall vascular health.Dr. Krishna Nagaradh: Diets rich in anti oxidants like vitamin A,C,E zinc, lutein and zeaxanthin play a vital role in protecting the retina. They are found in abundance in green leafy vegetables. Also foods like fruits and vegetables support the overall functioning of the eyes. To quit smoking is another major lifestyle modification needed to be adopted as it will reduce the oxidative stress over the retina and prevent its damage. Managing blood sugar and blood pressure levels. Protection of once eyes from harmful UV radiations by using protective glasses, keeping self hydrated, reducing screen time, getting enough sleep and avoiding frequent touching of eyes also plays role in maintaining eye health. Regular eye checkups which should include dilated eye examination for early detection of retinal pathology will avoid severe vision damage.Dr. Kalpana R: A well-balanced diet is the most important requirement for healthy eyes. Fruits, nuts, green vegetables are all essential for the function of the retina which carries the electrical impulses to the brain which is converted as an image for us to see. Without balanced nutrition the retina degenerates faster. A proper lifestyle is the quintessence of healthy eyes. Cutting down on screen time, having adequate amount of sleep, using the gadgets at a proper distance (60-70cm away) with anti-reflective screen, avoiding reading in dim lights or glaring lights, following the 20/20/20 rule which is only 20 minutes of attention to gadgets at a stretch, blinking every 20 seconds, and looking at objects 20 meters away; this is of utmost importance to prevent dry eyes and eye strain while working. Well balanced nutrition is mandatory, avoiding eye injuries (wearing protective goggles at necessary times) should be borne in mind.What’s one myth about retinal health you wish more people understood correctly?Dr. Yogesh Patil: People think that if their vision is good, their retina must be healthy. The truth is early retinal diseases are usually silent. Good vision does not equal a healthy retina. The only way to know is through a regular dilated retinal exam or imaging specially in at risk people.Dr. Krishna Nagaradh: The major myth which I have heard from many of my patients is that eye check ups need to be done only when they face a difficulty in vision. Regular eye checkups are must especially in diabetics cause early diagnosis and treatment can avoid major eye related complications in future.Dr. Kalpana R: A common myth about absent retinal diseases is that they can be cured at any time. But the fact is in some individuals the worst outcome can be averted while in some it can be prolonged. Take good care of your eyes and see the colors of the world with a Duchenne smile.This day is a reminder to check in on your eye health, because conditions like macular degeneration, diabetic retinopathy, and retinal detachment can sneak up without obvious symptoms at first. Regular eye exams are key. A quick visit can help catch problems early and protect your sight long-term.But it’s not just about doctor visits, your lifestyle plays a role too. Eating foods rich in antioxidants (think leafy greens, berries, and fish packed with omega-3s), wearing sunglasses to block UV rays, and keeping your blood sugar and blood pressure in check all support retinal health.So, on World Retina Day, give your eyes some love. Schedule that eye exam, grab a pair of good shades, and maybe even swap the fries for a salad, it’s a small step with a big payoff for your vision.
