Diabetic eye changes Flashcards
How do patients with bilateral diabetic papillopathy present
- reduction in visual acuity that is sudden
- does not fluctuate
- does not improve with a pinhole
- direct ophthalmoscopy would reveal swollen discs
How do patients present with bilateral macular oedema
- gradual decline in central vision
- miss patches of text when they read
- hard exudates within the macular - appear as yellow deposits with borders that are distinct
- diminished novel reflex
How do patients present with variable refractive change
- most likely in patients who have recently been diagnosed or who have diabetes that is uncontrolled
- fluctuations
- rapid reduction in the level of blood glucose
- report changes in vision such as short or long sightedness
How does variable refractive change happen in diabetes
rapid reduction in the level of blood glucose may alter the composition and thickness of the lens as a result of transient differences in osmotic pressure across the blood-ocular barrier and the lens capsule resulting in changes in lens hydration
How does bilateral cataracts occur
- cause a gradual decline in vision that does not fluctuate
- patients visual acuity may initially improve with a pinhole
- as the cataract develops the ability of the pinhole to correct the visual acuity disappears
What does dry eye syndrome feel like
- fluctuations in visual activity
- soreness s
- grittiness
- excess lacrimation
- blurred vision
- pain
- sensation of a foreign body in the eye
- vision improves with blinking
what can cause variable refractive change
- dry eye syndrome
What is posterior vitreous detachment
Posterior vitreous detachment is common in patients with diabetes, and occurs when the vitreous separates from the retina
How does posterior vitreous detachment present
- unilateral floaters
- flashing lights
How does retinal detachment present
- patients often describe a curtain being draw across their vision in one eye
Who does a vitreous haemorrhage occur in
- diabetes patient who have proliferative retinopathy
what are the signs of a vitreous haemorrhage
- obscures your view of the retina and causes dulling of the red reflex
How does uveitis presents
- painful
- photophobic
- red
- ciliary injection
- reduction in visual acuity secondary to inflammation and macular oedema
How does a cataract present
- decline in vision
- no improvement with a pinhole
- red reflex that is irregular
How do you treat macular oedema
- strict control of blood glucose and blood pressure
What is rubeotic glaucoma
- this occurs when new blood vessels that are abnormal grow not he iris and block the drainage of the fluid
- lad to glaucoma - it is a neovascular form of secondary glaucoma
How do you treat dry eye syndrome
- can treat dry eyes with topical ocular lubricants - tend to be prescribed for use during the day as they generally cause less blurring of vision
What are episodes of showers of floaters
- small vitreous haemorrhages secondary to neovascularisation
How does occlusion of the central retinal vein present
- dot blot and flame shaped haemorrhages throughout all four quadrants of the retina
- dilation of all branches of the central retinal vein
- cotton wool spots
- swelling of the optic disc
- macular oedema
How does occlusion of the central retinal artery present
- whitening or pallor of the retina
- cherry red spot in the centre of the macula
