Diabetic eye changes

Question 1

How do patients with bilateral diabetic papillopathy present

Answer 1

• reduction in visual acuity that is sudden
• does not fluctuate
• does not improve with a pinhole
• direct ophthalmoscopy would reveal swollen discs

Question 2

How do patients present with bilateral macular oedema

Answer 2

• 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

Question 3

How do patients present with variable refractive change

Answer 3

• 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

Question 4

How does variable refractive change happen in diabetes

Answer 4

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

Question 5

How does bilateral cataracts occur

Answer 5

• 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

Question 6

What does dry eye syndrome feel like

Answer 6

• fluctuations in visual activity
• soreness s
• grittiness
• excess lacrimation
• blurred vision
• pain
• sensation of a foreign body in the eye
• vision improves with blinking

Question 7

what can cause variable refractive change

Answer 7

• dry eye syndrome

Question 8

What is posterior vitreous detachment

Answer 8

Posterior vitreous detachment is common in patients with diabetes, and occurs when the vitreous separates from the retina

Question 9

How does posterior vitreous detachment present

Answer 9

• unilateral floaters

- flashing lights

Question 10

How does retinal detachment present

Answer 10

• patients often describe a curtain being draw across their vision in one eye

Question 11

Who does a vitreous haemorrhage occur in

Answer 11

• diabetes patient who have proliferative retinopathy

Question 12

what are the signs of a vitreous haemorrhage

Answer 12

• obscures your view of the retina and causes dulling of the red reflex

Question 13

How does uveitis presents

Answer 13

• painful
• photophobic
• red
• ciliary injection
• reduction in visual acuity secondary to inflammation and macular oedema

Question 14

How does a cataract present

Answer 14

• decline in vision
• no improvement with a pinhole
• red reflex that is irregular

Question 15

How do you treat macular oedema

Answer 15

• strict control of blood glucose and blood pressure

Question 16

What is rubeotic glaucoma

Answer 16

• 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

Question 17

How do you treat dry eye syndrome

Answer 17

• 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

Question 18

What are episodes of showers of floaters

Answer 18

• small vitreous haemorrhages secondary to neovascularisation

Question 19

How does occlusion of the central retinal vein present

Answer 19

• 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

Question 20

How does occlusion of the central retinal artery present

Answer 20

• whitening or pallor of the retina

- cherry red spot in the centre of the macula