What does an ophthalmological examination of diabetics include?
The review of diabetic patients with suspected diabetic retinopathy should include:
- Visual acuity test
- Measurement of intraocular pressure
- Examination of the anterior segment of the eye on a biomicroscope on a narrow pupil (we register the appearance of rubella-pathological blood vessels)
- If necessary, gonioscopy (examination of the angle of the anterior chamber of the eye) with the aim of finding pathological blood vessels if neovascular glaucoma is suspected.
After dilating the pupil, we proceed to the examination of the fundus, as follows:
- Contactless – with a magnifying glass of 90D or
- Contact method – panfundoscope
In addition to a detailed examination of the wide pupil, the additional diagnostic methods we use are:
- Optical coherence tomography-OCT – cross section of the yellow spot that we need to assess the condition of the yellow spot, diagnose macular edema, the type of edema, treatment options and monitoring the success of therapy, which can be: anti VEGF therapy, laser therapy or vitreoretinal surgery,
- Fluorescein angiography-FA – contrast image of retinal blood vessels,
- Ultrasound – B scan for inaccessible media of dense cataracts and vitreous hemorrhage to see the condition of the retina.
Examination by an ophthalmologist is necessary at the time of detection of the disease – diabetes, and then once a year if there are no changes or they are minimally present. If the changes have already developed, then controls for 4-6 months are advised, and if we have changes that require treatment, then according to the doctor’s indications. Intravitreal applications of anti-VEGF th in macular edema in patients with type 2DM are usually administered once a month. Laser photocoagulation in proliferative diabetic retinopathy is performed in several extensions, 3 to 4 at 1 to 2 weeks intervals.