Sunday, 8 November 2015

Opthalmology - Diabetes

Diabetes mellitus
Ocular involvement in diabetes is very common. Structure-wise ocular lesions are as follows:
1. Lids. Xanthelasma and recurrent stye or internal
2. Conjunctiva.Telangiectasia,sludgingoftheblood
in conjunctival vessels and subconjunctival
3. Cornea. Pigment dispersal at back of cornea,
decreased corneal sensations (due to trigeminal neuropathy), punctate kerotapathy, Descemet’s folds, higher incidence of infective corneal ulcers and delayed epithelial healing due to abnormality in epithelial basement membrane
4. Iris. Rubeosis iridis (neovascularization)
5. Lens. Snow-flake cataract in patients with IDDM, posterior subcapsular cataract, early onset and
early maturation of senile cataract
6. Vitreous.Vitreoushaemorrhageandfibre-vascular
proliferation secondary to diabetic retinopathy 7. Retina. Diabetic retinopathy and lipaemia retinalis
8. Intraocular pressure. Increased incidence of
POAG, neovascular glaucoma and hypotony in diabetic ketoacidosis (due to increased plasma bicarbonate levels)
9. Optic nerve. Optic neuritis
10. Extraocular muscles. Ophthalmoplegia due to
diabetic neuropathy
11. Changes in refraction. Hypermetropic shift in
hypoglycemia, myopic shift in hyperglycemia and decreased accommodation

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