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The commonest cause of blindness in young and middle-aged people in
the Western world is diabetes mellitus. Although the mechanism
underlying diabetic retinopathy is still not understood, the
technology to reduce its progress exists, provided treatment is
given at the appropriate time. Doctors caring for patients with
diabetes should be familiar with all aspects of diabetic
retinopathy as well as the other ocular complications of diabetes.
They also need a basic knowledge of the special techniques used in
the diagnosis and treatment of diabetic eye disease (fundus
fluorescein angiography, retinal photocoagulation, vitrectomy) and
to understand how these procedures affect the diabetic patient in
terms of limitation of activities and time off work. To ensure the
most efficient use of ophthalmic services a clear plan of referral
to ophthalmologists is required. These are the concepts on which
this guide is based, compiled by an ophthalmologist involved in the
treatment of diabetic eye disease and a physician with a special
interest in diabetes. In addition to doctors involved in the
management of diabetic patients, this guide may be of value to
ophthalmic opticians, medical students and nurses as a
self-instruction manual. ' 7 1 Examination of the Eye Testing
visual acuity Using the ophthalmoscope The normal fundus The
abnormal fundus Recording the findings 9 TESTING VISUAL ACUITY
Method Test one eye at a time. Test distant visual acuity. Correct
the refractive error if the visual acuity is worse than 6/6.
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