Diabetic Eye Clinic

Diabetic Eye Clinic

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It is the “disease of the retina” caused by microangiopathy due to long term effect of diabetes leading to progressive damage of the retina & blindness. Most common cause of severe bilateral visual loss in working age group.


It is the “disease of the retina” caused by microangiopathy due to long term effect of diabetes leading to progressive damage of the retina & blindness.

Most common cause of severe bilateral visual loss in working age group.

Risk Factors

  • Age at diagnosis of diabetes
  • Duration of diabetes
  • Poor metabolic control
  • Pregnancy
  • Hypertension
  • Nephropathy
  • Others – smoking, obesity, hyperlipidemia, anemia


  • Diabetic Retinopathy is a microangiopathy primarily affecting the precapillary arterioles, capillaries,
    venules and post capillary venules.
  • The basic component of damaging process are microvascular occlusion & microvascular

Capillary Changes

  • Degeneration & loss of pericytes
  • Thickening of Basement membrane
  • Damage & proliferation of endothelial cells

Hematological Changes:

  • Deformation of RBC & rouleaux formation
  • Increased plasma viscosity
  • Increased platelet stickiness & aggregation


  • Earliest sign of Diabetic Retinopathy.
  • Appear as tiny red dots.
  • It is focal saccular dilatation of capillary walls where pericytes are absent.
  • Located in the outer plexiform layer & inner nuclear layer.
  • Usually at posterior pole, especially temporal to the fovea.
  • In FFA — present at the edge of area of capillary non- perfusion (hyper fluorescence dots)

Dot & Blot Haemorrhage:

  • Due to rupture of wall of capillary or microaneurysm, giving rise to intra retinal haemorrhage.
  • If the haemorrhageis deep (i.e. in the inner layer of Outer Plexiform Layer) it is usually is round or oval (dot/ blot haemorrhage)

Flame Shaped Haemorrhage

  • Arise from superficial precapillary arterioles.
  • The haemorrhage is more superficial & in the nerve fiber layer, it takes a flame/ splinter shape as it follows the architecture of the nerve fiber layer.


Hard Exudates:

  • These are yellow deposits of lipid, lipoprotein & lipid filled macrophages within the outer plexiform & inner nuclear layer.
    They are arranged in clumps or form circinate pattern around the macula frequently at posterior pole.
  • These are signs of current/previous Macular edema.

Cotton wool Spot (soft exudates):

  • They are white fluffy lesions in the
    nerve fiber layer.
  • Caused by capillary occlusion at
    nerve fiber layer due to infarction.

Intraretinal microvascular abnormality (IRMA):

  • Abnormal dilated, tortuous retinal capillaries that act as a shunt between arterioles & venules.
  • It’s located within the internal limiting membrane.

Venous changes:

  • In the form of “beading”, “looping” & “severe segmentation” due to venous stagnation.



 MILD NPDR  micro aneurysms, retinal hemorrhage, hard exudates
 MODERATE NPDR  Mild NPDR plus cotton wool spots, venous changes & IRMA
4:2:1 rule
 Moderate NPDR plus one of —
micro aneurysms, retinal haemorrhage in all four quadrants
Venous changes in 2 or more quadrants
IRMA atleast in 1 quadrant
 VERY SEVERE NPDR  Two or more of the above features on severe NPDR

Proliferative Diabetic Retinopathy:
early/ mild/ non — high risk PDR

High Risk:

  ◉ New vessel on Disc:

  • More than 1/3rd of Optic disc diameter with/ without haemorrhage
  • Less than 1/3rd of optic disc diameter with haemorrhage (preretinal & vitreous haemorrhage)

◉ New vessel Elsewhere in Fundus:

  • More than 1/2 or equal to 1/2  of Optic disc diameter with/ without haemorrhage
  • Less than 1/2 of Optic disc diameter with haemorrhage. (preretinal & vitreous haemorrhage)

Clinically Significant Macular Edema

Modified Airlie- House criteria:

  • Retinal edema within 500 micron of central fovea
  • Hard Exudates within 500 micron of fovea centralis associated with adjacent retinal thickening
  • Retinal edema that is 1 disc diameter or larger, any part of which is with in 1 disc diameter of the fovea centralis.

Why us at IClinix Diabetic Eye Care?


◉ No Dilatation Required
◉ No Blurring Of Vision After Your Visit
◉ Time Saving
◉ No Stinging, No Eye Irritation


◉ Less sittings
◉ More Efficient Laser Deliveries
◉ Less Pain


◉ High Definition Imaging Of Your Retina
◉ Non Invasive Angiography Vs Conventional Angiography
◉ No Prick And Painless Angiography
◉ More Efficient Laser Deliveries
  • Advance eye scan for people for all
  • Captures digital photograph of layers of the retina
  • Easy and Painless
  • Can monitor the progression of any changes in your retina 

see your retina profile evolve over years under ICLINIX and compare yourself how the disease is controlled. We bring the FORUM for your individualised follow ups

  • Visualize integrated imaging data in seconds
  • Rapid and comprehensive: Fully assess retinal structure in seconds
  • Enhanced diagnosis and prognostication


  • Advanced Sutureless Vitrectomy/ Minimal Gauge Vitrectomy
  • Faster Recovery
  • Zero Astigmatism

1) History from patient
2) Clinical features
3) Ocular examination
      ◉ BCVA
      ◉ Slit lamp examination
          • Cornea
          • Iris
          • lens
      ◉ Funduscopy

Laboratory Test:

  • Blood sugar- FBS, RBS, 2HPPBS
  • Serum lipid profile
  • Medical evaluation of HbAlc


Ancillary Test:

  • Color fundus photograph
  • Fundus Fluorescein Angiography
  • 3D OCT
  • OCT Angiography
  • OPTOS (undilated retina workup)
  • ZEISS Retina Workplace

Laser Treatment:

  • Focal Laser
  • Grid Laser
  • Pan Retinal Photocoagulation

Intra Vitreal Injection:

  • Anti- VEGF injection