Well known in Bahrain as a specialist in retinal surgery and treatments, Dr. Samer Bashir is credited with the introduction of IntraVitreal injection technique to the kingdom. BTW team met him at The Gulf Diabetes Specialist Center (GDSC), where he enlightened us about the seriousness of Diabetic Retinopathy and the upcoming free event from GDSC for early detection of this silent vision destroyer.
Do you see quite a lot of patients here in Bahrain with damaged vision from years of uncontrolled diabetes?
Yes, sure I do. Bahrain actually ranks about 8th in the world for Diabetic Mellitus which is a very high instance of this disorder. The amount or percentage of people with complications of diabetics is again very high. This is associated with lack of awareness which is fortunately improving these days. People come to know about it only when it starts affecting their vision.
How and when does this diabetes affect human vision?
It depends! People who are genetically predisposed to diabetics get easily affected. The other reasons can be the number of years the diabetes has been there along with number of years it has not been under control and other added ailments like neuropathy or the effect to the nerves and poor sight. We always advise everybody who has diabetes to undergo an annual eye check up. If we just wait for the patient to complain it will be too late, and they will know they have been affected only when their vision is lost.
What treatments are available, if any, for this type of complication/damage?
It depends on the stage the patient currently is in. At the initial stages the patients won’t need any medicine but needs more control, encouragement and counseling on controlled lifestyle. Later there are chances of bleeding or pain which will require medicines. Very rarely we see patients who have been on ‘doctor shopping’ for a long period and they might need surgeries. This percentage is fortunately less when compared to the previous two. One needs to understand that both our eyes get affected by a disease, but at different degrees. This lets the doctor treat at least that one eye, even if the patient comes with issues that pertain to the other. There are many whom we can’t treat and that means they have lost their vision.
How can we identify diabetic retinopathy? What are the symptoms?
One of the most devastating complications of diabetes is blindness from diabetic retinopathy. Early detection and treatment can significantly reduce the incidence of blindness from retinopathy.
The trickiest part is that patients can always tell the problem with their sugar level but not their vision. Only after they lose differentiation between colours and everything they look at is in shades of grey, will they be able to identify the problem and it becomes too late to restore their vision.
The retina is the first thing to be affected which is away from the center of vision and that is why people fail to notice it initially. They lead a normal life reading and watching television without actually knowing their vision is getting affected. And when they consult us, they usually are too late.
How is retina photo screening done? How often should someone undergo such screening?
We have an event coming up which will give everyone a free chance to undergo retinal photo screening. It will be from 11th to 13th of May. This is one such easy method for the doctors and the patients to detect diabetic retinopathy, which is a silent destroyer of vision. The best part is that it is not scary at all! It involves the use of a fundus camera to take the photo of the back of the eye. Unlike other screening methods, no drops are needed for this. We also have a roll up scale showing how different stages of diabetic retinopathy look to compare it with the picture taken of your eye. It is not just for potential patients but to spread the awareness of taking care of your eyes. It is always good to have the screening done annually.
It is more like show and tell; which I prefer doing with my patients, to actually have the picture of their eyes taken and to explain to them the issues. It makes it easier for them to understand and take precautions the next time. It also gives them the confidence in the medication I might suggest.
You are the first person to introduce IntraVitreal injections in the kingdom. What inspired you take the step?
The reason I wanted to bring the injection to Bahrain was the need for such medicines that was arising during that time. The IntraVitreal injections were tested successfully in US and we decided to import one of them here while I was with my first employer here. Soon I had other colleagues of mine also wanting to use it and through our collaborations we were able to bring more quality to the medical treatments available in the Kingdom.
Can you please tell us in brief about IntraVitreal injections and its importance?
The eyes are a closed space and to have any medicine reach the inside, it needs to be highly concentrated. It won’t work with pills or drops. And that is when the IntraVitreal Injections play their role; by helping to reach the medicine to the actual point where it needs to go. During this procedure, your health care provider injects medicine into the vitreous, near the retina at the back of the eye. The medicine can treat certain eye problems and help protect your vision. It could be antibiotics or steroids as per the requirement. Now there are more modalities available in this which can fit the needs of different people.
What would be your advice to our readers?
If you know somebody who is diabetic; let them know that it is essential to do the ophthalmology check up. Along with the checkup it is equally important to lead a healthy lifestyle. After an age of 40 or 50, if you have a family history of any disease pertaining to the eye like cataract or glaucoma, have your eyes checked for sure.
Unlike a tooth cavity or a broken bone which can be easily fixed, a person’s poor vision might be at an advanced stage by the time he/she approaches the ophthalmologist. So make sure that you have your annual eye check up done and enjoy your healthy vision.