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Screening for Diabetic Retinopathy This presentation lasts approximately 10 minutes. Diabetic Retinopathy. Diabetic retinopathy is damage to blood vessels and tissue in the retina (the layer at the back of the eye) caused by diabetes.

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Presentation Transcript
slide1

Screening for

Diabetic Retinopathy

This presentation lasts approximately 10 minutes.

slide3
Diabetic retinopathy is damage to blood vessels and tissue in the retina (the layer at the back of the eye) caused by diabetes.
  • Diabetic retinopathy can affect anyone with diabetes, whether they have type 1 or type 2.
  • The condition can be well advanced before any reduction of vision is experienced.
slide4
Diabetic retinopathy is the main cause of blindness in the16 - 65 year old age group.
  • Early detection and regular monitoring are essential to reduce the risk of progression and improve the chances of successful laser treatment.
slide5
Good blood sugar and blood pressure control can reduce the risk of diabetic retinopathy and other complications of diabetes.
slide7
The retina is the innermost layer of the eye.
  • The retina contains photoreceptor cells (rods and cones) these cells work like the film in a camera by recording light which enters through the pupil.
  • This light information is sent from the retina, along the optic nerve and into the brain where the image is formed.
slide9

Main Features of the Retina

OPTIC NERVE

(OPTIC DISC 1.5mm)

FOVEA

MACULA

slide10

Optic Nerve (Optic Disc) - The nerve which connects the eye to the brain, and brings the retina its main blood supply.

  • Macula - Responsible for fine detail central vision (reading, writing etc.) and colour vision.
  • Fovea - The centre of the macula which provides the sharpest point of human vision.
slide12
Regular screening for diabetic retinopathy is the best way to reduce the risk of visual impairment caused by diabetes.
  • ***** PCT/Hospital provide annual screening for anyone with diabetes registered with a local GP.
  • The screening service uses a digital fundus camera (camera used to photograph the inside of the eye) which produces instant pictures. These can be shown to the patient during their appointment.
your screening appointment
Your Screening Appointment
  • When you arrive you will have to check in at reception.
  • You will be asked to take a seat in the waiting area until the nurse or screening assistant calls your name.
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First, your vision will be tested using a standard wall chart, the same sort that you use when you visit your optician.

slide15

Eye drops are then inserted into your eyes which

dilate your pupils and allow a clear view for photography.

This may sting at first.

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IT IS NOT ADVISABLE TO DRIVE FOR UP TO 4 HOURS AFTER THE EXAMINATION AS THE EYE DROPS CAN CAUSE TEMPORARY BLURRING OF VISION AND SENSITIVITY TO BRIGHT LIGHT!

It is advisable to bring sunglasses with you to wear when you leave.

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When your pupils are dilated (after about 15 mins)

the screener will take 4 photographs,

2 in each eye.

The screener will then show you the photographs

and point out any signs of diabetic retinopathy.

The results will be sent to your GP.

slide18

A letter outlining the results of the screening appointment and any further action required will be sent to you within 4 weeks of your appointment.

slide20

Micro aneurysms -

Are small red spots.

These are caused by

a swelling of very

small capillary vessels in

the retina, they are an

early sign of diabetic

retinopathy.

Micro aneurysms should be monitored every 12 months.

slide21

superficial flame shaped

haemorrhage

deep round

haemorrhage

Small blot

haemorrhages

Haemorrhages - Are red blots varying in size and shape.

These are small bleeds within the retina or near the

surface. There are several types .

Haemorrhages should be monitored every 3, 6 or 12 months depending on severity.

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Some Other Signs of Diabetic Retinopathy

Hard exudates -

Shiny pale white

or yellow sharp

edged features.

These are fatty

deposits caused

by leaking fluid.

Cotton wool spot -

White and fluffy

patches.

These are scarred

nerve fibres near the

surface of the retina.

Venous loop -

A loop in a blood

vessel, caused by

poor flow of blood.

These signs should be assessed by an ophthalmologist.

slide23

New blood vessels -

These appear wispy and

fragile. New blood

vessels form as a result of

existing vessel damage.

These vessels are

extremely weak and tend

to rupture very easily.

This causes scarring and a

build up of blood within the

eye.

New vessels require laser treatment.

slide24

Maculopathy -

This applies to most of the signs we have

already looked at when they occur on

the macula, close to the fovea.

Hard exudates

Haemorrhages

Micro aneurysms

Early maculopathy requires close monitoring. With hard exudates laser treatment is needed.

slide26
Laser treatment uses an intense beam of light directed onto the retina.
  • The treatment is given by an Ophthalmologist and is given as an outpatient.
  • There are three main types of laser treatment.
pan retinal photocoagulation
Pan-Retinal Photocoagulation
  • This is used to treat proliferative retinopathy (lesions which affect most of the retina with the exception of the macula). The laser is pointed at the outer part of the retina to reduce the risk of bleeding and scarring from repeated haemorrhages. This may take several sessions of laser treatment.
slide28

Panretinal Photocoagulation (PRP) - applied to treat proliferative diabetic retinopathy.

focal laser treatment
Focal Laser Treatment
  • Damaged blood vessels in the macula can leak fluid and exudates (fatty deposits) which damage your central vision. Focal laser treatment (often in combination with grid laser treatment) involves pointing the beam at the leaking blood vessels to prevent further leakage. This leakage and the resulting retention of fluid is known as Macular Oedema.
grid laser treatment
Grid Laser Treatment
  • This treatment applies low power laser burns to the retina in a grid pattern. This process removes the fluid from the back of the eye to improve sight by stimulating the cells that normally drain fluid away from the retina.
after laser treatment
After laser treatment
  • After laser treatment you will be followed up by the Ophthalmologist for several months. When the Ophthalmologist is happy that the condition has stabilised you will be returned to the screening service for regular monitoring.
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PLEASE CONTACT THE SCREENING SERVICE ON*** **** ****IF YOU HAVE ANY QUERIES OR CONCERNS REGARDING DIABETIC RETINOPATHY.

THANK YOU FOR

YOUR ATTENTION.

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