2. Objectives of presentationObjectives of presentation
Diabetes is one of the global health challenges,Diabetes is one of the global health challenges,
affecting about 3 % population of the world.affecting about 3 % population of the world.
Diabetic ophthalmopathy – a common, sight-Diabetic ophthalmopathy – a common, sight-
threatening complication of diabetes.threatening complication of diabetes.
3. DIABETES MELLITUS:
TYPE 1 (IDDM) ------- Insulin dependent diabetes
mellitus
TYPE 2 (NIDDM) ---- Non Insulin dependent
diabetes mellitus
16. OPTIC NERVE
Acute disc oedema
Mild acute AION
Optic nerve hypoplasia
Optic atrophy
EXTRA RETINAL EFFECTS OF
DIABETES ON EYE
17. Cranial nerve palsies
Focal small vessel occlusion & ischaemic demyelination----
cause
Occulomotor
Trochlear
&
Abducent nerves palsies.
EXTRA RETINAL EFFECTS OF
DIABETES ON EYE
19. Infectious diseases
ENDOPHTHALMITIS
MUCORMYCOSIS
cause internal and external ophthalmoplegia, Proptosis, ptosis.
HERPES ZOSTER INFECTION
may affect the trigeminal nerve. Cause Uveities and keratits.
EXTRA RETINAL EFFECTS OF
DIABETES ON EYE
21. TYPES OF DIABETES MELLITUS
AND
OCULAR INVOLVEMENT
Diabetic Retinopathy
Type 1 Diabetics 40%
Type 2 Diabetics 20%
22. Diabetic Retinopathy
EPIDEMIOLOGY
Prevalence increases with duration of diabetes & age.
After 20 years of diabetes, 99% pts with IDDM &
60% with NIDDM—have some degree of retinopathy.
70-80 million people affected worldwide.
5-8% population of Pakistan is affected.
5-10% of all diabetics have sight-threatening retinopathy.
23. CLINICAL CLASSIFICATION OF DR
Disease Severity Scale
• No Retinopathy
• NPDR
Mild
Moderate
Severe
• PDR
• ADED
• EDED
AMERICAN ACADEMY OF OPHTHALMOLOGY
24. RISK FACTORS
Onset / Duration of Diabetes:
DM before 30yrs of age —---- incidence 50%
DM after 10yrs ----- incidence 90%
Type of Diabetes ( IDDM --- 40%, NIDDM-----20%)
Age -----higher risk of PDR in younger diabetics.
Sex ------Men with IDDM have ↑ risk of developing PDR.
38. PRE-PROFLIFERATIVE DR
CLINICAL FEATURES
Large blot haemorrhages
Venous changes--- dilatation, beading, looping
IRMA
Capillary non-perfusion
MANAGEMENT
Close observation
Laser on progression
