Diabetes: the Eyes speak when the Body lies
A 57 years old patient presented with sudden Decrease in Vision in the right eye since 10 days. Left Eye was asymptomatic. No other associated ocular complaints like redness, watering. Patient did not have any systemic illness.
On examination, Best corrected visual acuity was 6/24 N10 in the right eye and 6/6 N6 in the left. Anterior segment examination was Within normal limits bilaterally. Retina examination revealed Superior central retinal vein occlusion (CRVO) in the right eye with scattered superficial and deep retinal hemorrhages and cystoid macular edema. The left eye fundus was within normal limits. Fundus photographs, Fundus fluorescein angiography (FFA) and Optical coherence tomography (OCT) were done.
Patient was advised basic routine lab tests to find out cause of CRVO, which revealed Blood Sugar Levels: Fasting 375mg% and Post Prandial 450mg%. Patient also had grossly deranged lipid profile, rest systemic findings were WNL. Patient was advised Anti-VEGF injection for cystoid macular edema (CME) for the right eye and was referred to a physician for Diabetes management.
(Right eye) FFA. Early and late image.
(Right eye) OCT
Right Eye Fundus Photography
Take home message
The Eye is a window to many systemic diseases like Diabetes , Hypertension and Rheumatoid Arthritis.
Do not neglect elderly patients with sudden Decrease Of Vision.
Identification and Systemic management of underlying disorder is most important to prevent involvement of other eye.