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Here you’ll find interesting cases of eye conditions along with news and developments in the ophthalmology world.

Cases are presented as an initial image with history and examination. Health practitioners are encouraged to deduce the condition, before further investigations, diagnosis and management are presented.

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Colour fundus photographs showing bilateral neovascularization at the optic discs and “elsewhere”, intraretinal microvascular abnormalities (IRMAs) and microaneurysms. Pre-retinal haemorrhage is seen inferiorly in the right eye and scattered fine hard exudates in the left eye.

Case 16

Figure 1A. Colour fundus photographs showing bilateral neovascularization at the optic discs and “elsewhere”, intraretinal microvascular abnormalities (IRMAs) and microaneurysms. Pre-retinal haemorrhage is seen inferiorly in the right eye and scattered fine hard exudates in the left eye.

Author: James Leong     Editor: Adrian Fung

A 22-year-old mother was referred after noticing new floaters in her right eye.

Case history

A 22-year-old mother (6 months postpartum) was referred after noticing floaters in her right eye. She also reported difficulty with her night vision and adjusting to dim illumination.

Past medical history included type 1 insulin dependent diabetes mellitus (IDDM) diagnosed at the age of 5 years. She admitted to poor glycaemic control as a teenager and during her recent pregnancy. Uncertain of her most recent HbA1c, the patient acknowledged her current blood sugar levels (BSL) were far from optimal. There was no known history of hypertension, hyperlipidaemia or renal impairment. Past ocular history included previous poorly tolerated retinal laser treatment but no prior intravitreal injections or surgery.

On examination visual acuities were 6/7.5 pinholing to 6/6 bilaterally. Intraocular pressures were normal. There was no neovascularisation of the iris or angles and the lenses were clear. Posterior segment examination demonstrated extensive new vessels at the disc and “elsewhere”, intraretinal microvascular abnormalities (IRMAs) and microaneurysms in both eyes. (Figure 1A and 1B). In the right eye there was associated pre-retinal and mild vitreous haemorrhage. In the left temporal macula scattered hard exudates were noted without significant associated retinal thickening. A moderate degree of panretinal photocoagulation laser scars were present bilaterally in the retinal peripheries.

Magnified view of the left optic disc showing neovascularization (“new vessels”).

Figure 1B. Magnified view of the left optic disc showing neovascularization (“new vessels”).

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