Eye Damage

Detection and surveillance

Detection and surveillance of eye problems are a routine part of Annual Review

Organize a recall system to ensure it occurs regularly for every individual

Measure or assess yearly :

visual acuity ( glasses or pinhole )

the lens and vitreous ( ophthalmoscopy )

the retina ( dilated pupils, retinal photography or skilled ophthalmoscopy )

related factors ( smoking / blood pressure )

Reassess after shorter interval ( 3-6 mo ) if :

pregnant ( see below )

new or progressive early or moderate non-proliferative retinopathy

blood glucose control recently improved

Eye disease management

Refer to ophthalmologist if :
		severe non-proliferative retinopathy
		proliferative retinopathy
		macular oedema or exudative maculopathy
		visual disability from cataract
		unexplained deterioration of visual acuity
		other eye disease of visual significance
		unrecognized eye lesions
Review and intensify management of :
		diabetic kidney disease
		blood pressure ( target <135/85 mmHg, or lower if kidney damage )
		blood glucose control
		blood lipid control ( if hard exudates )
		smoking
Attend to the psychological and social aspects of visual impairment where it develops

The primary management of diabetic eye disease is by careful attention to blood glucose control targets from the time of diagnosis