Diabetic retinopathy : Orthoptic Assessment and Considerations

Ocular Manifestations

Nonproliferative Diabetic Retinopathy

- Microaneurysms

- Retinal hemorrhages

- Exudates

- Macular edema

Proliferative Diabetic Retinopathy

- Neovascularization

- Vitreous hemorrhage

- Tractional retinal detachment

- Neovascular glaucoma

Visual Symptoms

- Blurred vision

- Metamorphopsia

- Scotomas

- Color vision deficits

Orthoptic Assessment

Visual Acuity

- Early detection of changes

- Monitoring disease progression

- Correlation with macular involvement

Contrast Sensitivity

- Impaired in diabetic retinopathy

- Sensitive to early retinal dysfunction

- Screening for subclinical disease

Visual Fields

- Evaluation of retinal ischemia

- Detection of scotomas

- Monitoring neuronal damage

Ocular Motility

- Assessment of cranial nerve palsies

- Evaluation of nystagmus

- Impact on binocular function

Rehabilitation Considerations

Low Vision Aids

- Magnifiers

- Telescopic devices

- Contrast enhancement

- Glare control

Eccentric Viewing Training

- Mapping of preferred retinal loci

- Saccadic eye movement therapy

- Adaptation to central scotomas

Occupational Therapy

- Environmental modifications

- Task simplification

- Assistive technology

- Activities of daily living

Multidisciplinary Management

Role of Orthoptist

- Early detection of complications

- Functional vision assessment

- Rehabilitation program planning

- Coordination with ophthalmology

Collaboration with Other Specialists

- Ophthalmologists

- Endocrinologists

- Internists

- Diabetes educators

Prevention and Prognosis

Risk Factors

- Glycemic control

- Hypertension

- Dyslipidemia

- Diabetes duration

Screening Recommendations

- Annual comprehensive eye exams

- Early intervention for vision changes

- Diabetes self-management education

Prognosis

- Early detection and treatment

- Individualized management approach

- Impact on quality of life

- Importance of multidisciplinary care

Conclusion

Orthoptists play a vital role in the assessment and management of visual complications associated with diabetic retinopathy. Comprehensive evaluation, low vision rehabilitation, and interdisciplinary collaboration are essential for optimizing patient outcomes.

Note : This document serves educational purposes exclusively and does not constitute medical advice or treatment guidelines