Diabetic Retinopathy - Zero to Finals

Question 1

Findings on fundus examination for pre-proliferative diabetic retinopathy?

Answer 1

• Venous beading
• Multiple blot haemorrhages
• Intraretinal microvascular abnormality (IMRA)

Question 1

Findings on fundus examination for background diabetic retinopathy?

Answer 1

• Microaneurysms
• Retinal haemorrhages
• Hard exudates
• Cotton wool spots

Question 2

Findings on fundus examination for proliferative diabetic retinopathy?

Answer 2

• Neovascularisation
• Vitreous haemorrhage

Question 3

What is the main distinction between non-proliferative and proliferative diabetic retinopathy?

Answer 3

Neo-vascularisation in proliferative diabetic retinopathy

Question 4

What are the complications of diabetic retinopathy?

Answer 4

• Vision loss
• Retinal detachment
• Vitreous haemorrhage (bleeding into vitreous humour)
• Rubeosis iridis (new blood vessel formation in the iris) - can lead to neovascular glaucoma
• Optic neuropathy
• Cataracts

Question 5

What is the management for non-proliferative diabetic retinopathy?

Answer 5

• Close monitoring
• Careful diabetic control

Question 6

What are the treatment options for proliferative diabetic retinopathy?

Answer 6

• Pan-retinal photocoagulation (PRP) - laser Tx across retina to suppress new vessels
• Anti- VEGF (vascular endothelial growth) medications by intravitreal injection
• Surgery may be required in severe disease (e.g. virectomy to remove vitreous humour)

Question 7

What is episcleritis?

Answer 7

• Benign and self-limited inflammation of episclera (outermost layer of sclera, just below conjunctiva)

Question 8

What type of disorders are commonly associated with episcleritis?

Answer 8

• Inflammatory disorders (rheum arthritis and IBS)
• Not usually caused by infection

Question 9

How does episcleritis present?

Answer 9

• Localised or diffuse redness (patch in lateral sclera)
• No pain )or mild)
• Dilated episcleral vessels
• No photophobia/discharge and normal visual acuity

Question 10

How do you differentiate between episcleritis and scleritis?

Answer 10

• Phenylephrine eye drops
• In EPISCLERITIS, causes blanching of episcleral vessels, so redness disappears
• In SCLERITIS, doesn’t affect scleral vessels so doesn’t change redness

Question 11

What is the management for episcleritis?

Answer 11

• Self-limiting, resolves in 1-2 weeks
• In mild cases, no Tx
• Symptoms relieved with mild analgesia (ibuprofen) and lubricating eye drops
• More severe cases treated with steroid eye drops