Diabetes is a leading cause of blindness in working-age populations in developed countries. Approximately 30% of diabetics have some form of diabetic retinopathy (DR), while around 5% progress to blindness from DR. Risk factors for DR include duration of diabetes, poor blood sugar control, hypertension, renal disease, pregnancy, obesity, hyperlipidemia, smoking, and anemia. DR is clinically classified from non-proliferative stages like background DR to more advanced proliferative stages involving new blood vessel growth. Treatment involves laser photocoagulation therapies while regular screening can detect DR early to prevent vision loss.

1. DIABETES AND THE EYE

2. EPIDEMIOLOGY
• Commonest cause of blindness in the
population of working age in developed
countries
• Prevalence of DR of any severity in the
diabetic population is 30% and prevalence
of blindness due to DR is approximately 5%

3. PATHOGENESIS

4. RISK FACTORS
• Duration of DM
• Control of DM. Will not prevent but delays
• Hypertension
• Renal Disease
• Pregnancy
• Obesity, hyperlipidaemia, smoking,
anaemia

6. CLINICAL CLASSIFICATION
OF DIABETIC RETINOPATHY
• Background
• Pre-proliferative
• Proliferative
• End-stage diabetic eye disease

7. Background
Blot haemorrhage
Exudate
Microaneurism

8. Diabetic maculopathy
Hard
exudate

9. Pre-proliferative
Vascular
tortuosity
Haemorrhage
CWS
Microaneurism

10. Proliferative retinopathy
NVD NVE
Laser burn scars
Pre-retinal
haemorrhage

11. Advanced diabetic eye disease
Preretinal fibrosis and
tractional retinal detachment
Rubeosis iridis

12. End-stage diabetic eye disease
• PHTHISIS
Shrunken, soft eye with
opaque vascularised
cornea and no visual
potential

13. TREATMENT
• LASER: Light
Amplification by the
Stimulated Emission
of Radiation
– Focal
– Grid
– Panretinal
photocoagulation

14. SCREENING
• No retinopathy or BDR with normal vision
– See yearly, or sooner if vision deteriorates
• Refer to ophthalmologist
– BDR with macular changes
– BDR with decrease in vision
– Pre-proliferative retinopathy
– Proliferative retinopathy