"Diabetes and tobacco are enemies of the retina"

We are in the year of the retina.This is clear about the public interest of "paying attention to a fact that is well known to the specialists: that three of the four most important causes of blindness in the developed world are due to diseases that affect this important tissue of the eye," says FranciscoGómez-in.

This ophthalmologist, professor of the specialty in the Faculty of Medicine of Santiago, head of the Service of the Compostela Sanitary Area and medical director of the Gómez-Ulla Ophthalmological Institute of Santiago, emphasizes the interest of this initiative.It is promoted by the Retinaplus+Foundation, of which Patron and Founder was;As has also been from the Spanish Retina and Vitreous Society, and President of the Galician and Spanish Societies of Ophthalmology.

-Why is the retina so important?

-The importance of the retina is that it is responsible for transforming the light that is received through the eyes into nerve impulses, which sends to the brain, where they will transform into images.In addition, by housing the macula in its center, it is also responsible for the central vision and to clearly see the details.If you do not take care of, the vision is quickly affected.

-Do you justify that the government dedicates a year in Spain?

-Yes it is.The year of the retina seeks to reduce avoidable blindness in our country, and improve knowledge of retinal diseases by the population.It is also intended to enhance multidisciplinary and coordinated attention by the different specialties.

-What specialties?

-In addition to the ophthalmology work, multidisciplinary assistance is required.Above all endocrinology, which pays care for diabetic patients, a health problem, and that its prevalence is increased alarmingly in the world developed in the coming years.Also Podiatry professionals, who treat the diabetic foot;or nursing and specialized educators.

-What are the most frequent retinal pathologies, and its prevalence?

- At present, high myopia, macular degeneration associated with age (DMAE) and diabetic retinopathy are ocular pathologies that suppose a higher risk to retina.Diabetic retinopathy is the first cause of irreversible blindness in working age and affects more than 5 0,000 people in Galicia and more than one million in Spain, and the risk of suffering from it increases in diabetic patients over time.The high myopia affects more than 900,000 people in Spain, and is a danger, because it can favor retinal detachment, submacular hemorrhages or growth of vessels below the retina, which end up causing blindness.

-And the DMAE?

-The DMAE is the first cause of blindness in people over 60 years in developed countries.Its incidence increases with age and aging.At present, about 40,000 people in Galicia and about 700,000 in Spain are suffered.Some 20,000 older people develop this pathology in Spain every year.

-Can't that increase be stopped?

-More than half of the new cases of DMAE never reach the consultation of the retina specialist, and 50 % of the diabetic people who reach legal blindness had never attended an ophthalmologist.These are aspects that need to improve.

-And what attributes that situation?

-It is due to many reasons.Perhaps the most important thing is the lack of awareness and knowledge of what is the risk of being blind.Therefore, professionals such as diabetes educators are very relevant, because they help improve the affected people of the disease, to feed properly, to have it well controlled to avoid their damage to the eye;But also others, as in the kidney, or in cardiovascular diseases associated with diabetes.

-Are theinherited-degenerative diseases?

-There are not many cases and are considered mostly among rare diseases.Despite being rare, we must take them into account, and we have technology that helps their diagnosis.In Galicia we have had cases of blindness due to adulterated pomace consumption.It can also cause blindness, by intake of preserves in poor condition;or alterations in the retina associated with certain medications may occur.But they are situations that we know well and know how to react if there are cases.

-From the Retinaplus+ Foundation you promoted blindness studies in Spain and Galicia.In Galicia the forecast is to reduce it by 20 % in the year 2020, will it be achieved?

-That is a WHO recommendation and we are.When I presided over the Retinaplus+ Foundation, I realized the importance of making that report, because there were no data on the main causes of blindness and visual disability, and the costs they supposed.We presumed that retina diseases were the main cause of blindness, and we confirmed it.In recent years it has been improved, but much remains to be done.Decreasing 20 % cases of visual disability in Galicia would mean savings of 18 million euros a year.

-What are the main threats to the retina?

-On all age, diabetes and tobacco.

-The tobacco?

-Yes, we know that the people who smoke have a greater risk of blindness.Tobacco boxes should include messages of the "smoking can cause blindness."

-What is the danger of tobacco?

-The nicotine and tobacco role favor blindness in the highest risk patients.In diabetics, for example, smoking increases the risk of getting worse.

-Are actions are foreseen in this area?

-In the proposals of the year of the retina are collaborating with entities such as the Spanish Society of Pneumology and Thoracic Surgery, to add efforts when preventing the adverse effects of tobacco on vision.And you can also take advantage of synergies of anti -tabaco campaigns of the public administration.

-What should be the conclusion of this year of the retina?

-Clear the entire population well, to communicate that the retina is very important to take care of our view and have more quality of life.Many people tell me in the consultation that they would prefer to die rather than get blind.

-Do you think it acts to get it?

-The Retinaplus+ Foundation has developed informative brochures on the main visual conditions, which should appear in primary, optical, pharmacies, hospitals, and other places of interest.It is necessary to make more ophthalmological reviews to achieve an early diagnosis, and thus avoid damage that affects the retina and that can derive in blindness.That is the great challenge of this important year.Many people tell me in the consultation that they would prefer to die rather than get blind.