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Fluorescein angiography
Fluorescein angiography
Fluorescein angiography is a diagnostic test that aids visualization of the blood circulation in the retina and choroid. Fluorescein is a water-soluble dye that is injected into a vein in the patient's arm. It travels through the blood vessels of the body thereby aiding multiple photographing of the retina. The images obtained help in detecting any swelling or leakage in the blood vessels. The patient's eyes are dilated with mydriatic eye drops so that photographs of the inside of the eye can be taken. Some patients may notice skin rash, itching or allergic reaction to the dye. Nausea or vomiting may be noticed. But this non-invasive test can usually be safely repeated. Abnormal results of fluorescein angiography test may indicate diabetic retinopathy, macular degeneration, or cancer. Ischaemia or oedema in the retina circulation can be detected with the help of fluorescein angiography
Ophthalmologist
An ophthalmologist combines the diagnostic skills of a clinician, the therapeutic skills of a physician, technical skills of a micro surgeon and psychiatric skills in understanding the patient's psychology in one. Since the eye is structured in such a way that its components are transparent, the opthalmologist is able to observe directly and read the abnormalities in a manner which is not possible for any other parts of the human body.
Professional qualifications for an ophthalmologist
Ophthalmologists are medical doctors who have completed medical school and four years training schedule in opthalmology after medical school. An opthalmologist can be a medical doctor with an M.D. degree in opthalmology or doctors of osteopathy D.O. In the US, four years of training after medical school is a must. The first year is an internship and then three years of training in opthalmology in a residency program approved by the Accrediation Council of Graduate Medical Education. An ophthalmologist may develop expertise in a sub-specialty such as:
Services rendered by an opthalmologist
By convention, an opthalmologist specializes in the medical and surgical care of the eyes. The opthalmologist aids in prevention of eye diseases and injury to the visual system. The full spectrum of care rendered by an opthalmologist includes:
Eye surgeon
An opthalmologist often performs surgery to prevent or improve vision related conditions. A variety of lasers are used nowadays to perform out-patient procedures which previously required admission to hospital. Also tremendous improvements in microsurgical instrumentations have led to development of operations not considered possible a decade ago. An increasing number of such surgeries are being performed by local anesthesia. The surgical work of a general opthalmologist includes:
Some common emergency of the eye that require immediate intervention by an opthalmologist are:
Medical ophthalmologist
A medical opthalmologist generally does not perform surgery. The sphere of interest embraces:
Diabetes Mellitus : Type 1 and Type 2
Diabetes can manifest itself in two different forms and severities. When there is an occurence of diabetes due to an inadequate production of insulin by the pancreas, it is a condition of Diabetes mellitus. Insulin is a hormone which regulates the level of glucose (sugar) in the blood stream. Glucose serves as a vital source of energy for all organs in the body and is the only source of energy that can be utilized by the brain. But insulin is needed to control the glucose levels in the blood so that the body can effectively use it for regulation of metabolism. Insulin is critical in the transport of glucose to the cells for energy metabolism.
The two forms of diabetes are discussed below:
TYPE 1 Diabetes: Diabetes of this kind usually manifests in childhood or adolescence. Patients suffering from this type of diabetes are dependent on insulin injections to maintain normal body chemistry. This type of diabetes can be inherited. If this is not tackled with insulin, diabetic ketoacidosis and death can result. Type 1 Diabetes is referred to as insulin dependent diabetes.
TYPE 2 Diabetes: Usually, middle aged and overweight people suffer from this type of diabetes when their blood sugar is higher than normal. This manifestation of diabetes is also known as adult onset diabetes. Insulin injections are not needed to conrol this form of diabetes but a suitable diabetes diet and weight reduction can help. But this form of diabetes can lead to long term diabetic complications.
Complications arising out of long-term diabetes
1. Diabetic Retinopathy: There is damage to the retina (perceptive structural tissue of the eye). This condition results in decreased vision and sometimes leads to blindness.
2. Kidney Disease: Impaired kidney function can be a resultant of long term diabetes. It can even lead to overt kidney failure.
3. Stroke: Diabetics have an increased risk of stroke.
4. Heart Disease: Increased risk of myocardial infarction (heart attack).
5. Peripheral Vascular Disease
6. Poor Wound Healing: Ulcers and foot problems are common
7. Decreased immunity to infection
8. Peripheral Neuropathy: Patients suffering from Diabetes face damage to the peripheral nerves and altered sensation. It is also accompanied by numbness, tingling and/or burning pain to the extremeties.
9. Females who are diabetic need to be carefully monitored during pregnancy
Type I Diabetes manifests itself in symptoms such as increased frequency of urination, increased thirst and hunger. Type I Diabetic patients also experience weight loss and increased fatigue. Read up the symptoms of diabetic ketoacidosis
Type II Diabetes is characterized by increased hunger and thirst and increased fatigue. Persons suffering from this form of diabetes face numbness or tingling in the hands and feet as well as frequent infections along with slow healing of cuts, ulcers and sores. Impotence is yet another resultant condition.
Random and fasting blood sugar testing can help in revealing any indications of diabetes. Examining the medical history combined with a physical examination is also done by a physician. To confirm the diagnosis, a Glucose tolerance testing is also done. Blood tests for kidney profile and blood counts are also done. Urinalysis will show the excess presence of glucose.
Treating Diabetes
1. Controlling the symptoms of diabetes.
2. Achieving and maintaining a desirable weight.
3. Achieving and maintaining a healthy level of physical activity.
4. Achieving and maintaining a nearly-normal blood glucose level (between 70 mg/dl and 140 mg/dl).
Treatment of type 1 diabetes requires adherence to a strict diabetes diet and regular doses of insulin. Failure to take care of the diabetic condition can lead to potentially serious outcomes. Blood glucose levels must be monitored so that complications are avoided. Diabetics must be trained to check their own blood and urine glucose levels. They can use the newer forms of ambulatory glucose monitors that can give you automatic readings and help in diabetes management. Avoiding sweets is an elementary precaution that needs to be followed. Many a time, oral hypoglycaemic agents (Orinase, Glucatrol) may be used for regulating blood sugar levels. Find out more on a diabetes diet (in total calories). You can seek help from an Internist or Endocrinologist
Use of Steroid medications (i.e. Prednisone and Medrone) can increase blood sugar levels. They can affect the control and treatment of diabetes. Beta-blocker antihypertensive medications are yet another set of medicines that can cause serious complications for the diabetic patient and should be avoided.
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