Disease-a-month : DM
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Tractional retinal detachments (TRD) occur as a consequence of various retinal pathologies but is most commonly associated with proliferative diabetic retinopathy (PDR). Monitoring for diabetic eye disease and early identification of TRD are crucial for preventing vision loss.
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Diabetic retinopathy (DR) is a leading cause of preventable blindness world-wide. Diabetic macular edema (DME) is the most common cause of moderate vision loss in patients with diabetes. Although treatments for DME have improved significantly over the past decades, the burden of this disease remains high for patients and the healthcare system alike. The role of the primary care provider is critical in the prevention and prompt referral for management of DME.
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Diabetes is one of the leading causes of morbidity and mortality in the United States. Patients with diabetes are at risk for multiple ophthalmologic complications including, but not limited to, cataracts, glaucoma, and retinopathy. Eye-exams are an important screening tool for patients with diabetes in order to prevent the more severe and vision-threatening sequela of disease. ⋯ However, recent estimates demonstrate that few diabetic patients meet the recommended screening guidelines. Appropriate referral and follow-up is important for monitoring the ophthalmologic conditions associated with diabetes. Our purpose is to review current recommendations for ophthalmic screening for patients with diabetes in a clear and concise manor for primary care physicians.
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Diabetic papillitis (used interchangeably with diabetic papillopathy) is a relatively rare ocular manifestation of systemic diabetic disease. Found in both type 1 and type 2 diabetic patients, it manifests as swelling of the optic nerve head in one or both eyes and is considered a diagnosis of exclusion. ⋯ The pathogenesis is poorly understood. The following discussion will cover the presentation, diagnosis, treatment, and prognosis of diabetic papillopathy.
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Diabetic keratopathy is a significant problem that is commonly overlooked and underdiagnosed by many healthcare providers. More than half of the diabetic population can have tear film changes, corneal epithelial abnormalities, neurotrophic keratopathy, and increased postoperative surgical complications. Clinical manifestations can be quite variable and thus diabetic patients with ocular complaints should be referred to an eye care professional. Treatment of diabetic keratopathy can be managed with a stepwise approach that includes increasing corneal surface lubrication, preventing infections of corneal epithelial defects with prophylactic antibiotic eye drops, and reducing exposure to avoid corneal melting .