6. Medical management
• Improve control of blood sugar
• treat hypertension
• treat obesity, dietary advice
• stop smoking
• Extra vigilance during pregnancy
• attend screening
7. Health Education, Diet and Control
•improved blood glucose / blood pressure
control
•reduced risk of diabetic eye disease by 1/4
•reduced risk of severe visual impairment by
more than 1/2
•kidney damage by 1/3
•stroke by 1/3
8. Treatment options
•Monitor with dilated eye exam and check
vision
•Capture fundal image and use telemedicine
•Know when to refer and what patient should
expect
•Options once referred
•Laser
•Anti VEGF agents
•Surgery
•Control of secondary problems e.g. glaucoma
16. When to refer?
•Do you have any mechanism for telemedicine?
•Sudden onset reduced vision- look for red reflex- if
none then refer within weeks. If good red reflex
consider other causes and refer as soon as possible
•Gradual progressive reduced vision not corrected
with glasses/pinhole - refer within months
17. Summary
•Have I educated the patient and relatives?
•Have I checked the vision?
•Have I explained they need to have the eyes
checked every year?
•If I find something wrong what are my options?
•Once they have had treatment don’t forget to
follow them up