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EDITORIAL

WRITTEN BY ASHOK CHOWDHURY

 

Software developed by W.M.L. in transforming text into Braille as transcribed 18 volumes of Tagore’s publication into Braille to be kept as an asset at State Central Library for the sightless readers, who will be coming for ages to come. This is indeed a colossal task. Which has been accomplished by W.M.L. recently. In fact this would not have been possible, if Media Lab Asia did not join hands with financial support. Thanks to Mr. Gautam Burman, C.E.O. (W.M.L) and Mr. Shankar Nath Goswami, M.D. (Media Lab Asia) this dream came to reality with wide appreciation from one and all.

 

On 9th May 2007 in the auspices of Tagore’s birth centenary a function was held at ‘Gyan Mancha’ in presence of honorable Minister in charge of Information Technology, Govt. of West Bengal and other important personalities. The minister handed over the publication to the State Central Library and Forty institutions for the sightless, where given ‘Galpa Guchcha’ in Braille to enrich their school library.

 

It was enrich very attractive cultural function, where so many print & electronic media came for coverage. All the dignitaries expressed their satisfaction through their speeches. Mr. Ashok Chowdhury highlighted on the importance of reading in between the lines of Tagore literature to find Oasis of their deserted lives.

 

Thanks to advancement of Information Technology the education of the sightless has been provided with good impetus on optimum level. This stupendous task will remain as a historical record in the technological history of the Webel Mediatronics Limited.

 

 

INFORMATIVE  NEWS  FOR  THE  VISUALLY  IMPAIRED

 

1. N.A.B. West Bengal organized a seminar at Rotary Sadhan on the responsibility of the Corporate Sector towards disability in the birth centenary of Dr. Helen Keller on 27th June 2007. Representatives from Police, Bank, Media and Law were invited to answer the questions interrogated by the participants. It was infact a panel discussion on the different problems faced by the disability. The seminar was conducted by Miss. Kanchan Gawa, Secretary of the Concern. At the end justice Shyamal Sen answered certain points in matters of law interrogated by the participants.

 

2. Calcutta Blind School organized inauguration of the newly-constructed prayer hall in the campus on 27th June 2007 in the auspices of Helen Keller’s birth anniversary. Mr. Sadhan Gupta, Mrs. Kumkum Chakraborty, Mr. Kishor Ghosh were present at the inaugural function. Secretary of the institution invited all institutions for the blind to witness the occasion.

 

3. Bharat Chamber of Commerce organized a seminar at Park Hotel on the application of computer in the social sector. The minister in charge of I.T., Govt. of West Bengal was the chief guest with other important personalities. Mr. S. J. Dutta, representative from Webel demonstrated the development of different Software by W.M.L. before the spectators. President of B.C.C. and person entrusted with I.T. sector nicely highlighted on the application of computer in Social Sector. It was followed by deliberation on development of Software for Cerebral Palsy patients by Mrs. Subhodra kaur, Director of the Concern. Finally Mr. Ashok Chowdhury, Ex-Principal, Calcutta Blind School was requested to speak on application of I.T. in special sector. He elaborately explained about development of different Software for the visually challenged by W.M.L. and emphasized on the need of employment for the Sightless through proper training on I.T. in West Bengal. Miss. Keka Sharma, Secretary, nicely organized the Seminar by her present and impressive personality.

 

4. Ladies Circle India arranged a function at Light House for the Blind on 25th June 2007, where few sightless students were given Hepatitis-B on their Health Care programme. Mr. Ashok Chowdhury was felicitated by the concern for his contribution to education of the sightless. Ladies Circle India is a nice social organization, which renders assistance on health care and education of the under privileged section of the society. This is a national organisation, which offers help all over India by forming different groups, which actively help the society silently up to 40years of age as per their stipulation.

 

5. W.M.L. distributed 18 volumes of Tagore’s publication in Braille to the State Central Library to be kept as an asset for the Sightless readers in presence of Prof. Debesh Das, Minister in charge of I.T. Govt. of West Bengal. Thanks to Mr. Shankar Nath Goswami, M.D. (Media Lab Asia) and Mr. Gautam Burman, Chief Executive Officer W.M.L. this publication and distribution has been possible. This was organized by W.M.L. on 9th May 2007, in the auspices of birth centenary of Rabindra Nath Tagore.

 

Inclusive Education for the Visually Impaired:

Status and Unreached Areas

Hena Basu, Hon Secretary, Society for the VH

 

Introduction:

Education is the fundamental right of a child ensured by the Constitution of independent India. It took the Persons with Disabilities (Equal Opportunity and Full Participation) Act, 1995 to open admission of children with low vision, vision impairment and total Blindness to their nearest primary school, as a right with dignity. Inclusion of Persons with Disabilities in society in general and in family in particular, is fraught with struggle. Infrastructure, resources and a barrier free environment, which are essential prerequisites for Inclusion, are almost always missing in our country. In this article I have attempted to draw attention to the current status of Inclusive Education for visually impaired children and highlight the major tasks that await our massive involvement if we set the goal of achieving Education For All by 2020.               

 

Experience:

As a result of our close involvement with the development of the Integrated Education for the Disabled (IED) component of WBDPEP and Sarva Sikhsha Mission, in West Bengal since 1998 in the capacity of a member of the IED State Resource Group first and later as the State Level Resource Organization (SLRO), we had an opportunity to interact frequently with Government Free primary school teachers, Special educators (Visual) and District Level Resource Organizations (DLRO) who have been overnight called upon to reach the target of Education For ALL without the back up of an appropriate infrastructure, resources and adequate, trained and experienced professionals.

 

It appeared equally convincing that unless this project is implemented rightaway in WB activating all the existing Government and non-Government network, the literacy and mainstreaming for children with visual impairment, will never be a reality that we so desperately cherish.

 

Coverage points:

In connection with this WB Government project we have traveled long distances touching remote points in the Sunderbans in South Bengal in particular and other districts in general on invitation from the WBDPEP & SSA & later SSM authorities to sensitize regular schoolteachers.

 

Challenges:

Challenges commonly faced are as follows: children with low vision, vision impairment and total blindness are identified through Medical Camps, ICDS Workers and door to door survey. Under pressure for enrolment, these children, mostly first generation learners, are made to report to the nearest local schools irrespective of their appropriate school readiness skills. Service of Special Educators is practically non-existent considering the urgency of the demand. Parents, mostly belonging to low socio-economic groups and daily wage earners, are resisting this sudden encroachment into their right to decide whether their children need to acquire literacy at all.

 

Government resources:

The following figures will give some idea about the state of affairs in the District of the South 24 Parganas:

 

No of Govt. Free Primary Schools: 3586

No of Govt. Free Primary School Teachers: 9544

No of ICDS Centers: 5098

No of Sishu Siksha Kendras (SSK): 1394

No of visually impaired children enrolled in neighbourhood regular schools: Male 937, Female 522

No of Special Educators in position (Visual, Hearing & MR/CP): 18

No of Special Educators (Visual): 6

No of District Level Resource Organizations: 8

 

Source of data: DISE

Advantages with visually impaired children:

Compared to loss suffered by a child with hearing impairment, cerebral palsy, autism, mental retardation, the loss of vision can be largely compensated for with early intervention and skill development of a visually impaired child. Since traditional teaching is primarily oral, with appropriate sensory training and curricular plus skills, a visually impaired child can progress fast in a general classroom and sometime top the class. We must identify the important stakeholders in the field of education of the blind and the visually impaired; they are the parents, general school teachers, special educators, key persons in the community, functionaries in the Department of Education, Health and Welfare. Bridging the gap between the unreached, marginalized blind child in the rural area living in an environment of acute poverty, illiteracy, low esteem and neglect on one hand and the urban centered trained professionals and resources requires focusing on certain areas highlighted below.

 

Changes and innovations in the delivery system for serving blind children Serving education support to blind children through several networks supported by trained professionals, supply of aids and appliances, continuous awareness programmes through local events and emphasis on an attitude that investment on the education of the blind children in the long run contribute to the prosperity of the country.

 

Infusing a positive philosophy as early as possible Profound lack of strong early-intervention programmes based on high expectations and positive approaches to blindness put blind children at a significant disadvantage. Often parents of blind children are confronted from the beginning with negative stereotypes and low expectations from people around them. Children who lack opportunities and expectations early on are labeled as slower and a general acceptance of this lag grows out of a misguided nation. All efforts must be geared to encourage parents to take an active, leading part in enabling their blind children to keep up with their peers.

 

Better educational programmes for parents, paraprofessionals and teachers In addition to standard training programmes conducted by RCI, it is important that regular short and part time or distance courses on teaching of Braille, preparation of talking books in recorded cassettes, use of Abacus for mathematics and learning to make low cost innovative teaching aids for concept development are structured and conducted by resource education bodies.

 

Pursuing meaningful research that will drive better instruction for blind children Research projects undertaken in India are either too theory-oriented or fragmentary. A large number of research areas from improving Braille literacy to tracking performance of blind children in order to measure the effectiveness of the services they receive lay unattended. Also a documentation of struggle and achievements of blind adults who have reached great heights and are contributing to the society through their talents, in India and abroad will go a long way in inspiring parents and blind students themselves.

 

Conclusion:

Inclusion is a concept with a wide periphery. When a society attempts to include persons with disabilities whom it has segregated for ages, a new page is turned in history. Right from belief, conviction, attitude, support to infrastructural and resource opportunities require reshaping and remodeling to welcome with dignity those who were dropped behind. It is our priority, it is our country’s priority and we stand by our pledge of reaching Education To Sightless Citizens.

 

 

Technology Of Visually Impaired

 

After crossing so many milestones and undergoing trials and trileulation the education of the Visually Impaired has been provided with technological advancement. Many assistive devices have helped the Visually Impaired to achieve  y  levels of independence through more access to information. In fact the recent advances in technology have brought in revolutionary changes in the quality of life and patterns of work and leisure for the Visually Impaired. We know that technology has a tremendous potential for making the Visually Impaired economically independent, therefore it is the need of hour to improvise technology in the absence of universal designs. New areas of technological development have to be explored so that the objective of the equal opportunities for the Visually Impaired is achieved.

 

So far as daily living activity is concerned, Visually Impaired person have been more independent. They need not ask for time. They have their Braille watches; they have Braille thermometers to access the temperature by themselves. Even more Braille email sending option has been made accessible to the Visually Impaired. In fact the aim of education is to make sightless more independent in dealing with day to day matters.

 

Even in the matters of mobility and orientation, some technological devices have been prepared namely “Path Finder” developed by Massachusetts Institute of Technology. It is developed for the deaf blind in USA. This device generates a “TickTick” sound from 6 feet distance. So that the sightless can avoid that direction and turn to the path where there is no obstacle.

 

Recently there has been some important development in technology in matters of education and rehabilitation of the Visually Impaired. Webel Mediatronics Ltd. Under the sponsorship of Department of Information and Communication Technology, Govt. of India has developed different Software and Hardware under the Braille literacy program in Thirteen Indian Languages.

 

It may be noted in this connection that at the initial stage it was a humble attempt of enlightening the education of the sightless in a restricted manner. There was a cloud al over the sky lightening and flashing from time to time exposing the promising future with the development of technology based Hardware and Software and information system platform. In course of time the patch of clouds has been removed in constant process of research and users’ feedback. The sunny sky appeared to be coming in view for maintaining a repository of reading materials including newspapers and magazines.

 

Now we may notice the continued development, so far achieved by WML in developing different Software in a right direction. We may mention serially to assess the progress.

 

·          Software for Braille to Text conversion using normal computer keyboard in Thirteen Indian Languages.

·          Software for conversion of Mathematics & Scientific books in Thirteen Indian Languages to Braille script and printing the same.

·          Software for self teaching of Bharati Braille using normal computer keyboard in Thirteen Indian Languages useful for teachers and instructors of Blind schools.

·          Software for self evaluation of the visually impaired students using normal computer keyboard in Thirteen Indian Languages useful for teachers and instructors of Blind schools.

·          Software for memory game and Braille quiz using normal computer keyboard in Thirteen Indian Languages useful for teachers and instructors of Blind schools.

 

It is crystalline clear from the above development that the effort of WML in enhancing technological advancement in matters of education and rehabilitation is really laudable.

 

But we have many miles to go before we reach our target. Now technology should be targeted to provide scope for rehabilitation of the visually challenged in different segments of the society, so that the visually impaired may live with the joy of life, enjoying equal rights, equal opportunity and equal participation like their seeing peers.

 

Ashoke Chowdhury,

Ex-Principal, Calcutta Blind School.

Guest Lecturer Calcutta University.

 

 

 

Changing Pattern of Visual Impairment

Prof. I.S. Roy, MBBS, FRCS, FRC Ophth (Lond)

Director, Netra Sevashram

Commissioner, St. John Ambulance Brigade

 

This is a changing world and in the last decade we have noticed several new trends in the pattern of blindness due to research progress. There is a distinct shift from infectious blindness condition to non infectious chronic diseases. For Example:

1. Ophthalmic neo-natorum is nil;

2. Trachoma and onchocerciacis are rare;

3. Blindness from small pox is nil;

4. Malnutrition and Vit. Deficiencies causing Keratomalacia are rarely seen;

However the corneal blindness is still rampant from fungus and viral infection.

 

These have been made possible through public awareness created by Govt. & NGO’s with co-operation of the ophthalmic community. Needless to say several International Organisations doing commendable work viz. RCSB, Danida, Rotary International, Lions International, Seva Foundation, Cristopher Blindnen Mission and many others.

 

Despite all these the global blindness is increasing. In fact the slogan “HEALTH FOR ALL by the year 2020” has failed and we foresee that the blindness figure of 12 million will be doubled by the year 2020. The reason is simple–the population at large is growing older. As a result the Senile Cataract, Age related Mac. Dgn., maculopathy of Diabetes and BP are seen in large number. There is not only a changing pattern in the disease but also a changing trend in the treatment modality. Patients demand foreign IOL and phaco. Same result of visual improvement can be obtained at a cost of Rs. 1000/- only from our hospital. The laser therapy is very expensive where Photo Dynamic Therapy is necessary.

 

Glaucoma is another disease which escapes the attention in many cases and the treatment has also been made expensive with Auto Perimetry, OCT, Laser therapy, Xalatan like drug. Extremely surprising is that the demands are from the economically weaker section of the society. The craze for the very expensive type of treatment has been induced into the patients brain by the media like T.V. and unethical publicity of the medical community. Now a day the Ophthalmologists are more keen to copy the very expensive treatment modality available abroad.

 

To cope with the increasing blindness population several measures have been taken. They are as follows. The slogan is “Vision 2020-Right To Sight”.

·          Infrastructure development-Base hospital are now replacing the old camps in school and dharmashalas; Govt. has supplied microsurgical facilities to subdivisional hospitals.

·          Manpower development to train surgeons in Micro Surgery techniques; more important is to train mid level ophthalmic personnel (MLOP). Many hospitals like that of Netra Sevashram are active in develop their own in house training to meet their requirement. The MLOP are trained in OPD management, Indoor and operation theatre management. All of them are excellent assistants during surgery like IOL implantation, squint and many other intraocular surgeries.

·          Indigenous Ophthalmic equipments, suture, IOL, spectacles at an affordable cost; in this context I am boldly announcing that a cut bifocal could be obtained cheapest at a cot of Rs. 20/-. Even then the profit was RS. 2/-. However one patient of mine paid 26,000/- for his bifocal, that also did not give him the satisfaction while playing golf and simultaneously fiddling with his cell phone.

·          Country-wide Pediatric Unit to combat neglected childhood blindness. Many cases of ROP and refractive errors and amblyopia are still untreated as there is only a few eye specialist who can either detect these or the interest of the ophthalmologists is least on these cases.

·          Eye bank or eye collection center to cope with the corneal blindness through keratoplasty.

 

Of late the monomanual phaco is in the process of transition to sleeveless Bimanual micro phaco emulsification. Only difference is: vision is same in both system, but expense is just doubled (!).

 

Before I conclude, a couple of lines on “Tele Ophthalmology” needs a mention. This is Remote Ophthalmology with the help of a well equipped bus with high tech ophthalmic services at the door step of patients in remote villages. This Tele Bus through satellite establishes connection with Chief Ophthalmologist hundreds of Km away who then advises the treatment. It is wonderful-saves time and travel cost for the rural victims.

 

However the Tele Bus needs huge money from a “Generous Donor”.

 

“The more you will sacrifice yourself for the welfare of the universe, the more you will realize the splendour of your own self in the universe. You will then feel no difference between yourself and the universe. You shall have become at one with the universe.”

Swami Asimananda Saraswati

 

 

The Problems of Diabetic Retinopathy and Other Ocular Complications of Diabetes Mellitus.

--Dr. Santanu Sen, M.S., Ph.D.

(Life Member, Sri Sri Bijoykrishna Ashram Relief Society)

 

Diabetic retinopathy is one of the most common causes of blindness in all developing countries, particularly in India. It is now-a-days regarded as the sixth important cause among all the blindness, while cataract still remains the most important and number one cause of blindness in our country. Surprising only about twenty years back diabetic retinopathy occupied the Seventeenth position among all the causes of blindness, from which it has ascended to the Sixth position putting forward a great challenge to the ophthalmologists, to the physicians and to the patients, in general, as well.

 

It is a matter of speculation why there is sudden rise of diabetic retinopathy cases. The reason is probably due to increasing longevity of diabetic patients due to improved mode of treatment. Diabetic Retinopathy, the gravest ocular complication of Diabetes Mellitus was found to have related with age and diagnosis of Diabetics and the ‘duration of diabetes.’ More the duration of diabetes and more the age at diagnosis, more is the chance of developing Retinopathy. Hence, increased longevity increases the chance of developing Diabetic Retinopathy. Moreover, increased stress or strain of present day life, faulty dietary habit, hereditary factors, and many other Complex factors, not clearly understood till this day, have attributed to the alarming rise of diabetic patients in our country and consequently the diabetic retinopathy cases. World Health Organization (WHO) has stated that 2% of Indians are diabetic, although recent studies done in India report that it is between 5-10%. WHO also warned that by 2025 there would be 57.5 million diabetic patients in India, one fourth of whom would feared to be affected by Diabetic Retinopathy. It is also true, improved Hitech method of investigation and diagnosis, increased in numbers of hospitals and diagnostic clinics, improved sense of awareness among the patients in comparison to the yester years, have brought forward more and more diabetic retinopathy cases for treatment than in the past. Whatever may be the reason or reasons behind, it is fact that the blindness due to Diabetic Retinopathy is increasing in an alarming spree in the recent years which should be dealt with immediately with all our forces.

 

Diabetes is one of the oldest diseases known to mankind. Its history is as old as that of the history of medicine itself. In pre Christian era, Susruta first described it in Hindu Medicine as ‘Madhumeha’ or ‘Honey-sugar’ as early as in 700 B.C. The disease was already known to others of the enlightened Hindu Civilisation centuries earlier. In 1921, in Toronto, F.G. Banting and C.H. Best discovered and isolated Insulin, the active principle of the beta-cells of islets of Langerhans of Pancreas. Since then a series of research works had been carried out by numerous research workers for decades to know the exact etiology of this complex disorder which is still far from adequately understood. Diabetes mellitus is generally regarded as a disorder of the Carbohydrate metabolism characterized primarily by hyperglycemia and glycosuria with secondary anomalies of the metabolism of proteins and fats. Inappropriately elevated blood sugar levels represent only one aspect of this widespread metabolic disorder. Thirst and weight loss and sometimes ketosis are usually associated with it in long standing cases. Although the exact nature of the biochemical derangement is not fully understood, still it has been found that diabetes affects almost all systems and almost all structures of the body, principally the Kidneys, the Eyes, the Heart muscle and the nervous system. Many of these abnormalities have a vascular basis and the essential lesion appears to be an affection of capillary basement membrane. In long standing diabetic patients, of more than five years duration, some degree of retinopathy, back ground or proliferate, is common in association with some degree of renal affection. Many ophthalmologists and physicians, therefore, prefer to use the term ‘Diabetic Renal Retinal Syndrome’ instead of the term ‘Diabetic Retinopathy’ alone.

 

Diabetics mellitus may affect all the structures of the eyes, causing various ocular complications, ranging from simple Madarosis to complicated Vitreous haemorrhages. Cataract is very common in diabetic patients. Apart from ageing process, diabetes has been considered to be one of the major risk factors of Cataract. The high blood sugar levels in diabetes may cause tissue disruption and intumescences by osmotic changes induced via Aldose Reductase (AR) mediated polyol pathway. Snowflake lental opacities are characteristically found in young-diabetics and subcapsuller other types of lental opacities are common in adult ones. These types of lental opacities usually mature more rapidly than ordinary senile cataracts and progress to the point of requiring extractions at an earlier age than those in non-diabetics. Complicated cataract secondary to vitreous haemorrhage, sometimes accompanying by a polychromatic lusture are also found in diabetic patients. Refractive changes are common in diabetics. In about 33% cases, myopia changes are frequent and only initial symptom of diabetic, although this type of myopia always disappears within a few weeks of initiation of treatment of the diabetes Hypermetropia, though less frequent, may develop overnight some days after institution of Insulin therapy in young adult diabetics, but always disappears over a period of 4-6 weeks. Iritis with oedema and vascularisation of iris and albuminous exudates in the pupil are common in diabetic patients. It is more common and a grave sequel of cataract extraction in diabetes than in non diabetics. Rubeosis Iridis, in which new blood vessels first appear on the anterior surface of the iris at the papillary margin and gradually extend towards the angle of anterior chamber is a serious complication of diabetes; almost always bilateral and usually associated with proliferative retinopathy. These are more common in younger patients with long-standing diabetes and in order patients with short period of D.M. These usually lead to painful intractable haemorrhagic glaucoma with gross visual loss. Sudden and rapid onset of palsy of third nerve and sixth nerve (Diabetic Ophthalmoplegia) with sparing of the pupil and severe pain in the same side of the face and head are also common complication seen mostly in elderly who have had diabetes for many years. Optic atrophy has also been reported in some diabetic patients suffering from some hereditary syndrome.

 

The gravest ocular complication of diabetes mellitus is diabetic retinopathy, first described by Lober, as early as 1875, soon after the invention of ophthalmoscope. It is present in less than 1% patients under the age of 40 years, but about 50% patients are affected in diabetics who have has diabetes for 10-15 years. The state of retinopathy varies from the presence of only micro aneurysms as in back ground retinopathy, to the appearance of retinal hemorrhage and/or exudates (Non-proliferate diabetic retinopathy) to fibrous proliferation, new vessel formation (Proliferate diabetic retinopathy). Ultimately vitreous detachment, vitreous hemorrhage, retinal detachment very often make the condition worse still, ultimately causing total visual loss. As was stated earlier, most of these abnormalities have a vascular basis, essential lesion appears to be a thickening of capillary basement membrane with re-duplication and multi-layering of basement membrane, loss of mural cells and pericytes, seeping of blood, etc. (Ashton). Capillary closure and arteriolar pathology may result in alternation in overall haemodynamics of the retina. Collection of fluid at macula, macular oedema, causes blurring of vision in about 50% cases of proliferative diabetic retinopathy. Diabetic retinopathy usually affects both eyes.

 

The management of diabetes mellitus and its ocular complications are very important. The patient should realize, as early as possible, that it is upon him the success or failure will depend. The doctor can only advise. The aims of treatment are-The correction of hyperglycemia and glycosuria. Prevention of ocular complications and Abolition of symptoms as per practicable while avoiding hypoglycemia.

As soon as the diagnosis of diabetes is made, the patient should be told that he has diabetes, at the same time he should be reassured, especially if a near relative has/had complication of the disease. The patient should seek the advice of a physician immediately and adhere to the treatment as per his direction, very often for the remainder of his life. The mode of treatment should be i) Diet alone ii) Diet and oral hypoglycemic drugs as in type II. DM iii) Diet and insulin as in type I. D.M.

 

Diabetic Retinopathy often has no early warning sign. But, no one should wait for symptoms to develop. Everyone with diabetes should have a comprehensive dilated eye examination at least twice in a year, in a good eye care center. During the initial stages of diabetic retinopathy, no treatment is usually needed, unless one has macular edema. Patients with diabetes should control the levels of blood-sugar, blood-cholesterol and blood-pressure strictly to prevent progression of the retinopathy. Hypertension and elevated blood-cholesterol were found to accelerate and increase retinal hemorrhage and exudation in diabetic retinopathy. Proper controlling of these will, therefore, help to reduce the risk of vision loss at early stage. The diabetic patients who complain of seeing a few specks of blood or spots, floating in the vision, should have a thorough eye examination and may need treatment before more serious bleeding occurs. The patients should undergo Angiography (FFA) and optical Coherence Tomography (OCT) wherever available. Multifocal ERG will be of help in estimating the visual potential of the patients. Proliferative retinopathy should be treated with laser, namely, focal, grid or panretinal photo coagulation. The procedure, called scatter treatment, helps to shrink the abnormal blood-vessels. 1000 to 2000 laser burns are to be placed in the areas of the retina away from macular, causing shrinkage. Two or more sessions are usually required to complete treatment. Colour vision, night vision and also some side vision may be lost or reduced, but still it can save the rest of the sight. The laser treatment is beneficial before new fragile blood vessels started to bleed. In case of vitreous haemorrhage, vitrectomy may have to be done. Intravitreal steroid for macular oedema and pituitary ablation are sometimes needed in rare occasions.

 

Even diabetic patient, his physician and ophthalmologist should therefore work unitedly and adhere to the appropriate line of treatment after periodical comprehensive eye examination, regular blood-sugar and blood-pressure check up to reduce the risk of visual loss of the patient and to help the country to have less number of blind people.

 

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