Seeing Is Relieving

Diabetic retinopathy, a leading cause of blindness, treated with eye injections.

Dr. Jaya Kumar at Florida Retina Institute in Lady Lake, Mount Dora and Clermont, treated Glenroy Washington for diabetic retinopathy using injections and laser therapy.

Glenroy experienced improved vision after laser therapy on his right eye.

Glenroy Washington was introduced to music at age 7, when he followed his grandmother to church services in his native Jamaica. He was singing professionally by age 17, and at 26 his career got a huge boost when he crossed paths with a music legend.

“In 1981, I was working with a band called Happiness Unlimited in Ocho Rios, Jamaica,” Glenroy remembers. “A man named Steveland Morris, who most people know as Stevie Wonder, came to Jamaica for vacation. He stayed at my hotel and we ended up on stage.

“For the two weeks that Stevie Wonder was in Jamaica, we were on stage every night. He decided to take my band back to the US, which was a real adventure. But once I came to America, I decided to stay and start a family. And here I am.”

Since becoming a professional in 1973, Glenroy has traveled extensively across the country and around the world with various bands, mostly as a drummer, but he also sings.

“People started saying, We hear that sweet voice, but we don’t know who is singing. You need to come up front,” Glenroy relates. “I had to choose between playing the drums and being a lead singer. I chose the drums.”

Glenroy toured as part of a band for many years but eventually became a solo artist. Now at age 65, Glenroy maintains a successful performing and recording career, but in 2019, he suffered a setback when he began to experience issues with his vision.

“I have diabetes, and even though my doctor told me to get it under control, I lost track of it while I was in Europe,” he says. “That’s when my vision problems started, and at first everything started looking blurry and I couldn’t see to drive, especially at night. It was so bad that I wasn’t able to renew my driver’s license, so my wife had to drive me everywhere. I also couldn’t see words in print. I used the highest strength reading glasses, and even then I had to get up close to see.

“When I returned from Europe, I started visiting Florida Retina Institute. They showed me there was blood leaking from behind my retinas and said I needed injections into my eyes.”

The treating physician, Jaya B. Kumar, MD, is a board-certified, fellowship-trained retina specialist. She diagnosed Glenroy with advanced diabetic retinopathy, the most common eye disease associated with diabetes and one of the leading causes of blindness in American adults.

“When Glenroy presented to us in spring 2019, he had significant retinal disease in both eyes,” Dr. Kumar recalls. “We started him on a treatment plan that included injections of medication and laser therapy to both eyes.”

“At first, I was scared just thinking about getting injections in my eyes,” Glenroy admits. “But I didn’t feel a thing and soon became very comfortable with them. Dr. Kumar is very gentle and takes her time, and every time I ask, Did you do it yet? Her answer is, I’m done.

ABCs for Retinal Health

When blood sugar is elevated due to diabetes, it causes inflammation of the blood vessels. The smallest vessels – in the eyes, kidneys and brain – are the most vulnerable. Diabetic retinopathy results when the tiny vessels in the retina become damaged.

“Inflammation from elevated blood sugars causes blood to leak from the blood vessels into the surrounding tissues,” Dr. Kumar elaborates. “In the case of the retina (layer of tissue at the back of the eye), the compromised vessels leak blood, cholesterol deposits and fluid into the retina, which can cause the vision to become blurry.

“This typically occurs in the early stage of diabetic retinopathy, called nonproliferative diabetic retinopathy. We generally manage patients in this stage by observing the condition and working with the patients and their primary care provider or endocrinologist to lower the patients’ blood sugar, blood pressure and cholesterol, and maintain a healthy lifestyle.”

There’s another complication that can arise when blood vessels are inflamed. Often, they become unable to carry blood to the peripheral, or outside edges, of the retina. This leads to ischemia, a lack of oxygen to those areas, which can result in tissue death.

“When this happens, the eye tries to compensate by creating new blood vessels,” Dr. Kumar informs. “But these new blood vessels are abnormal and fragile and can rupture and bleed, and wreak havoc in the eye. They can cause scar tissue to form and even lead to a retinal detachment. This advanced stage is called proliferative diabetic retinopathy.

“If a patient progresses to this stage, or if they develop diabetic macular edema, a condition in which the center part of the retina – or macula – begins to swell, we typically start them on a course of intravitreal injections.”

The retina specialists at Florida Retina Institute use two main classes of medication for intravitreal injections. One is a steroid that reduces inflammation and swelling in the eye. The other is an anti-VEGF drug, which stands for anti-vascular endothelial
growth factor.

“VEGF is a protein that stimulates blood vessel development,” Dr. Kumar explains.

“With Dr. Kumar’s treatment, my eyes started clearing up. I can now read the tiniest words and numbers, which makes me more confident.” – Glenroy

Anti-VEGF medications such as bevacizumab (Avastin), ranibizumab (Lucentis) and aflibercept (Eylea) help stop the abnormal vessels from forming, as well as leaking blood and fluid into the retina, which can lead to vision problems,” Dr. Kumar says.

Dr. Kumar and her colleagues may choose to perform laser therapy on patients with proliferative diabetic retinopathy. This prevents abnormal blood vessels from forming in the peripheral retina and affecting vision. The procedure is called
panretinal photocoagulation.

“We utilize a special laser to create a series of tiny burn spots on the retina that stop the abnormal blood vessels from growing and leaking,” Dr. Kumar details.

Glenroy has already had laser therapy on his right eye, and he notes that he now sees “really well” out of that eye.

“The laser was just like the injections; it didn’t hurt at all,” he recalls. “It just felt like someone was touching my eye. The procedure was also really quick, probably about 15 to 20 minutes. Soon, I’ll be getting laser therapy on my left eye. I think then my vision is going to be really, really good.”

The best defense against diabetic retinopathy is early detection, which requires visiting an eye doctor routinely for dilated eye exams to evaluate the health of the retinas. Patients should also work closely with their primary care provider or endocrinologist to keep their diabetes under control.

“I tell my patients to remember the ABCs when it comes to diabetic retinopathy,” Dr. Kumar stresses. “A is for A1C, which measures blood sugar levels. It should be less than seven. B is for blood pressure. Managing it is really important to prevent progression of diabetic retinopathy. C is for cholesterol. Keep it low, And S is for smoking. Don’t do it.”

Provider Succession

Early in his career, Michigan native Gary Bunch moved between jobs – and states – several times before settling into a human resources position for an electric utility in Akron, Ohio. He stayed in that job for 12 years, but then his employer went through a radical change. And so did Gary.

Background: Dr. Jaya Kumar at Florida Retina Institute in Lady Lake, Mount Dora and Clermont, treated Gary Bunch for diabetic retinopathy using injections and laser therapy.

Gary’s diabetic retinopathy is being well controlled with the help of Dr. Kumar’s injections.

“The utility merged with a couple of other companies, so I took an early opt-out package and started my own consulting business,” he shares. “I did independent consulting for 16 years, and then the same utility invited me back. I worked in the nuclear division for another seven years after that.

“When I went back, I was responsible for organizational effectiveness, which involved succession planning, executive development and executive coaching. Basically, I worked to maintain solid leadership for the company. I retired in 2015. We stayed in Akron until my wife retired last year and then moved to Florida in March 2020.”

Gary spends his retirement enjoying the outdoors and devoting time to family. He likes boating but doesn’t want the hassle and expense of boat ownership. He found the perfect way around that impasse.

“We belong to Freedom Boat Club, which allows us to take out a boat of our choice at will anywhere in Florida and across the United States,” Gary discloses. “We like to go out on the lake here in Leesburg and over in the Gulf of Mexico. It’s like having our own boat, but not really.”

While Gary relishes his liberty in retirement, he continues to be responsible for caring for his health needs. He lives with diabetes and its complication diabetic retinopathy, two conditions that traveled with him from Ohio to Florida.

“I’ve had diabetes for about 20 years. Four years ago, I was diagnosed with swollen retinas,” he details. “I had a relationship with a retina specialist in Akron who was great. My condition required that I get shots in my eyes about every two months.

“When I was moving to Florida, I asked my doctor for a referral. He said that I should try to connect with Dr. Kumar. He said he had worked with her in the past and she was excellent. That’s what led me to Florida Retina Institute.”

When Gary met Dr. Kumar, she picked up where his retina specialist in Ohio left off and continued with injections for his diabetic retinopathy. But before each injection, Dr. Kumar carefully evaluates the condition of Gary’s retinas and looks for any signs of vision loss.

“Each time I go in for an injection, I’m put through a series of tests on my eyes,” Gary confirms. “They not only check my vision, they also do a scan of my retinas to judge how much the swelling has increased or decreased.

“The injections sound gross, but they’re really not. They use powerful numbing drops to numb my eyes. When it comes time to actually do the shot, Dr. Kumar comes at me from the side of my eye, so I don’t see it. I know what she’s going to do, but it’s done before I even know that she did anything. It’s pretty painless, and I don’t have to fear that I’ll see a needle coming at my eye.”

“When I first examined Gary, he had pretty well-controlled diabetic retinopathy with a little diabetic macular edema in the center part of his vision,” Dr. Kumar reports. “We are managing his condition with injections, and he has adjusted with a healthy diet and lifestyle. He is doing very well and has maintained excellent vision in both eyes.”

The underlying cause of Gary’s retina condition is his diabetes. He works with an endocrinologist to control his blood sugar levels, but Dr. Kumar offers advice on controlling blood sugar levels as well.

“That’s one of the things that I really appreciate about Dr. Kumar,” Gary states. “She’s always asking questions and giving me insights on how to handle my diabetes. I appreciate that she’s treating the cause of my problem and not just the symptoms.”

Overwhelming Response

Diabetes is a chronic disease that caused Gary’s and Glenroy’s diabetic retinopathy. Managing blood sugar levels is an essential component to their overall treatment at Florida Retina Institute, which is ongoing.

By following his treatment plan, Gary realized significant improvement in his retinal status.

“Since I’ve been working with Dr. Kumar, my progress is really going well,” he enthuses. “The swelling in my retinas has gone down at each visit with her. Based on my last appointment, I may reach a point in another couple of visits where I’ll just need maintenance treatments as needed rather than scheduled injections.”

Glenroy has achieved excellent results as well.

“Since I’ve been working with Dr. Kumar, my progress is really going well. The swelling in my retinas has gone down at each visit with her.” – Gary

“With Dr. Kumar’s treatment, my eyes have started clearing up,” he reports. “I can now read the tiniest words and numbers, which makes me more confident. After she did the laser on my right eye, my vision improved so much that I can see things I’ve never seen before. I got overwhelmed when I looked at the ground and saw ants crawling. I haven’t seen that in a long time.

“I’m still not driving, but I figure when I get the laser therapy on my left eye and all of the treatment is put together, I’ll be able to go back and get my driver’s license replaced.”

Both men are impressed with Florida Retina Institute in general and Dr. Kumar in particular. And they’re willing to share their opinions with others.

“I really liked my retina specialist in Akron,” Gary notes. “He did a great job, and I didn’t think I could like anybody more. But I love Dr. Kumar. She’s an absolutely marvelous doctor who really knows her stuff. One of the things I really like about any doctor is when they’re personable, and Dr. Kumar embodies that. She asks good questions, listens to my answers and acts upon what I say.”

According to Gary, the staff at Florida Retina Institute also has a leg up on their counterparts in Ohio.

“When I went for my injections in Akron, it was at least a three- to four-hour process to go through all of the steps involved,” he reports. “I just learned to accept that. But at Dr. Kumar’s office, it never takes more than an hour for the whole process because they are so efficient with the steps. So, beyond question, I recommend Dr. Kumar and Florida Retina Institute.”

Glenroy agrees wholeheartedly.

“Dr. Kumar is awesome. I love her,” he says. “And her treatment is good, really good. I would recommend Dr. Kumar and Florida Retina Institute to anybody, for real!”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb
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    • Florida Retina Institute

      Founded by James A. Staman, MD in 1979, Florida Retina Institute has 19 locations throughout Central Florida, North Florida, and Southeast Georgia. They have proudly delivered Excellence in Vitreo-Retinal Diseases and Surgery for 40 years. T... Read More

    • Jaya B. Kumar, MD

      Jaya B. Kumar, MD, is board certified by the American Board of Ophthalmology and the National Board of Medical Examiners. She earned a bachelor of science degree in the Honors Program and a Doctor of Medicine degree at St. Louis University in S... Read More