Dr Rameez Hussain : «Protecting the vision of diabetic patients is our top priority»

You may blame your blurry vision on fatigue or excessive screen time. But what if your eyes were actually sending you a warning about your blood sugar? Few people realise that diabetes doesn’t just impact your heart or kidneys; it can quietly damage the tiny blood vessels in your eyes, sometimes leading to irreversible vision loss. In fact, diabetes is one of the leading causes of preventable blindness worldwide. The good news? Early detection and proper management can make all the difference. To better understand how diabetes affects eye health and what tests you can do to protect your sight, we interviewed Dr Rameez Hussain, Lead Consultant – Ophthalmology Services and Senior Consultant – Vitreo-Retina Surgery at C-Care Wellkin Hospital.

Every year, on November 14, World Diabetes Day serves as a global reminder of a condition that continues to affect millions, often silently. At C-Care, this day is more than a date on the calendar; it’s an opportunity to raise awareness about a disease that is frequently underestimated. Many people living with diabetes don’t realise that the condition can also affect their eyes, sometimes with serious consequences. Vision problems can develop gradually, and by the time symptoms appear, the damage may already be done. The truth is no one is completely safe from these complications.

«According to available data, the prevalence of diabetic eye complications in Mauritius is comparable to that in India. What’s particularly alarming is the growing number of patients under the age of 40 presenting with advanced stages of diabetic retinopathy. We are seeing more young adults with serious retinal damage due to diabetes», notes Dr Rameez Hussain.

**The relationship between diabetes and eye health ? **

The relationship between diabetes and eye health is direct and significant. According to Dr Rameez Hussain, high blood sugar levels caused by diabetes can damage the tiny, delicate blood vessels in the retina, the light-sensitive tissue at the back of the eye. This damage can lead to a variety of serious eye diseases, often progressing without noticeable symptoms in the early stages.

Do you know that Diabetic Retinopathy is the most common diabetic eye disease? It develops gradually, moving from mild to more advanced stages. At any point, Diabetic Macular Edema (DME) can occur, a swelling in the central part of the retina (the macula) caused by fluid leakage. As Dr Hussain explains, «this edema is the most common cause of defective vision in patients with diabetic retinopathy».

But that’s not all. People with diabetes also face an increased risk of cataracts, a clouding of the eye’s lens that tends to occur earlier and more frequently than in non-diabetic individuals. Additionally, there’s a higher likelihood of glaucoma, a condition where elevated eye pressure damages the optic nerve. In fact, diabetes significantly raises the risk of a severe type known as Neovascular Glaucoma. Even seemingly minor issues, such as dry eyes and lid infections, are commonly observed among diabetic patients. While they may appear harmless, they can cause discomfort and signal the need for closer monitoring of overall eye health.

Warning signs you should never ignore :

«In its earliest stages, diabetic retinopathy often has no symptoms at all. This is why annual dilated eye exams are essential, even if your vision seems perfect», explains Dr Rameez Hussain.

As the condition progresses, some warning signs may begin to appear. A diabetic patient might notice fluctuating, blurry, or wavy vision throughout the day, or experience an increase in floaters: those dark spots, strings, or cobweb-like shapes that drift across the field of vision. Some may develop areas of missing or shadowed vision, whether in their central or peripheral sight, while others find it increasingly difficult to see at night. Dr Hussain warns that any sudden change in vision, such as a shower of new floaters or the sensation of a curtain moving over the eye, is a medical emergency that requires immediate attention.

How often should diabetic patients have their eyes checked ?

Dr Rameez Hussain emphasises the importance of regular screenings. «Every diabetic patient should have a yearly dilated eye examination, even if their vision appears perfectly normal», he advises. Once a diagnosis is made, the frequency of follow-up visits will depend on the stage and severity of the condition. Regular monitoring allows ophthalmologists to detect any progression early and intervene before irreversible damage occurs.

Tests that help detect complications early:

Detecting diabetic eye complications at an early stage is important to prevent irreversible vision loss. According to Dr Rameez Hussain, several specialised tests allow ophthalmologists to monitor subtle changes long before noticeable symptoms appear.

Here are some of the tests used :

Visual Acuity Test : The standard eye chart test. Measures how well you see at various distances. It establishes a baseline for your central vision but can be normal in early retinopathy.

Dilated Pupillary Exam (The Most Critical Test) : Eye drops are used to widen (dilate) your pupils. This allows the ophthalmologist to get a full, clear view of the retina, optic nerve and blood vessels at the back of the eye. It is essential for spotting early signs like microaneurysms, tiny hemorrhages and exudates.

Digital Retinal Imaging (Fundus Photography) : A specialized camera takes wide-angle, high-resolution photographs of the retina. Provides a permanent record of the retina’s condition, allowing the doctor to monitor for subtle changes over time. It’s often used as a screening tool in conjunction with the dilated exam.

Optical Coherence Tomography (OCT SCAN) : A non-invasive imaging scan that creates cross-sectional, high-resolution images of the retina. It is exceptionally good at detecting and measuring macular edema (swelling), which is a major cause of vision loss. The OCT can reveal structural changes within the retinal layers that is invisible to the naked eye during a standard exam.

Fluorescein Angiography (FA) : A diagnostic procedure where a yellow dye is injected into a vein (usually in the arm). As the dye circulates through the blood vessels in the retina, a special camera takes sequential photographs. It highlights blood flow in the retinal vessels, pinpointing damaged areas and abnormal new blood vessel growth. This is typically used if complications are suspected or to guide treatment.

C-Care’s commitment to protecting vision in diabetic patients :

At C-Care, protecting the visual health of diabetic patients is a key priority. Through its Community Eye Health Services, the hospital has launched the Diabetic Eye Screening (DES) Program, a dedicated initiative aimed at detecting eye complications early and ensuring continuous care.

Patients registered under the DES program benefit from a comprehensive eye examination, including a dilated retinal check-up and digital fundus photography to document retinal health, all offered as part of an affordable package. The system also provides automatic reminders for follow-up visits and standard blood investigations. In addition, a referral network connects patients to screenings for nephropathy and neuropathy, two other common microvascular complications of diabetes.

According to Dr Rameez Hussain, the ophthalmic department is equipped with state-of-the-art diagnostic and treatment technologies. «We have the latest versions of Spectral Domain and Swept Source OCT scans, which allow us to take high-resolution photos and scans of the retina without dilating the eyes. A digital ultrasound B-scan helps detect bleeding and retinal detachments, while the latest angiography system enables detailed retinal imaging without the need for fluorescein dye injections», he explains.

C-Care also boasts an exclusive ophthalmic operating room capable of managing nearly all complications of diabetic retinopathy, including retinal detachments and vitreous bleeding. «We use three state-of-the-art surgical machines from the US, Germany, and Switzerland», adds Dr Hussain. «Our department routinely performs procedures using FDA-approved eye injections and implants, and we have secured the newest retinal lasers for precise and safe treatments.»

Demonstrating its commitment to excellence, C-Care’s ophthalmology department shares its surgical videos on the American Academy of Ophthalmology website and other educational platforms. «Our affiliations with the European Society of Retina Specialists and the American Society of Retina Specialists allow us to remain at the forefront of global treatment standards for cataract, retinal, and other eye conditions», concludes Dr Hussain.