Psychophysical abnormalities are commonly found in diabetic patients and they manifest as poor night vision (dark adaptation) and poor recovery from bright lights (photo stress) . Color vision also suffers alterations in patients with diabetes ,blue-yellow discrimination being affected earlier than red-green discrimination. Clinical examination should include best corrected visual acuity, slit-lamp examination to detect iris neovascularization, intraocular pressure because of the increased risk of glaucoma, gonioscopy to rule out angle neovascularization and fundus examination following pupillary dilatation to assess the severity of DR. A number of tests ancillary to the clinical examination may enhance patient care, the most common including color fundus photography, fluorescein angiography, ultrasonography and optical coherence tomography.
Color fundus photography
Being a more reproducible technique, color fundus photography is frequently used in clinical research studies. It may be useful for documenting significant progression of disease and response to treatment, but it is rarely valuable in cases of minimal DR. Also, for detecting retinal thickening associated with macular edema and fine caliber NVD or NVE, clinical examination appears to be superior.
In selected patients with DR, fluorescein angiography is most helpful to assess the severity of DR, to determine sites of leakage in macular edema, to judge the extent of capillary nonperfusion and to confirm neovascularization . Still, we must be aware of the potential risks associated with the procedure because severe medical complications may occur, including death .
In diabetic eyes with op...
... middle of paper ...
...l. The patients received either intensified or standard treatment with hypogycemic agents, targeting a HbA1c of 6% respectiv 7.0–7.9%. The trial analysed a subgroup of 2856 patients concerning the relation between glycemic control and incidence and progression of retinopathy and the results showed that glycemic control reduce with 33% the risk of progression.
There are some metaanalysis showing that effect of metabolic control on retinopathy is overestimated and there are not sufficient data to sustain that a relative risk reduction will apear after improving HbA1c . Disglycemia can be involved in progression of retinopathy as hypoglycemia is also underestimated. In the group with intensive treatment a 30% increase of severe hypoglycemia was noted compared with standard group, but still are not enough data to blame hypoglycemia for progressing retinopathy.
Need Writing Help?
Get feedback on grammar, clarity, concision and logic instantly.Check your paper »
- Prior to an initial diagnosis being formulated, an extensive psychiatric evaluation and formulation would need to be completed, which would include a mini mental status exam, an extensive family history, previous psychiatric history, developmental and social history, substance abuse history, possible differential diagnosis and rule outs for other medical or neurological concerns. According to the Pocket Guide to the DSM -5 Diagnostic Exam (pg.11) “a good diagnostic interview produces a diagnosis, it also generates questions you will need to ask as you seek further understanding.... [tags: Differential Diagnosis]
1226 words (3.5 pages)
- Genetic testing is used to determine the risk of a patient or patient’s offspring developing genetic diseases. This is done with DNA sequencing in adults and preimplantation genetic diagnosis (PDG) on embryos. These methods of genetic testing are effective means of determining the likelihood of developing diseases such as Huntington’s disease, a disease resulting from trinucleotide repeat on chromosome 4p16.3 that causes uncontrollable muscle movement and decrease in cognitive function. However, they only determine probability, which isn’t an entirely reliable means of knowing whether or not symptoms will arise.... [tags: huntinton disease, dna]
1085 words (3.1 pages)
- The diagnostic process for personality disorders currently covers a broad scope of various tests and symptoms, causing a source of frustration for psychiatrists (Aldhous). The symptoms and side effects of several personality disorders can tend to blur together, making diagnosis challenging (Aldhous). Most psychiatric patients are diagnosed with several personality disorders at once, with twenty percent of people with personality disorders simply diagnosed with a “personality disorder not otherwise specified” (Aldhous).... [tags: diagnosis, behavioral therapy]
1191 words (3.4 pages)
- Autism is defined as a pervasive developmental disorder in which the patients have severe impairments in social interaction, including verbal and non-verbal communication and general cognitive development. According to the DSM-IV Autism Spectrum Disorders are characterized by developmental delays in children when dealing with socialization and communication, along with restricted, repetitive and stereotypical patterns of behavior. Those with autism display the inability to communicate with the world around them.... [tags: Differential Diagnosis]
1262 words (3.6 pages)
- Diagnosis is the process of identifying a particular condition via a systematic way. Differential diagnosis is the method of pinpointing all possible aetiological factors that are related with all clinical signs and symptoms and thus, precisely differentiating diagnosis until an accurate conclusion is made. Differential diagnosis is essential especially in field of neurology where many diseases share similar characteristics but has no definite examination or neurological test: Parkinsonism, migraine, amyotrophic sclerosis and also, multiple sclerosis.... [tags: Differential Diagnosis]
1293 words (3.7 pages)
- Cholesteatoma is a growth of excess skin or a skin cyst (epithelial cyst) that contains desquamated keratin and grows in the middle ear and mastoid (Thio, Ahmed, & Bickerton, 2005). A cholesteatoma can grow and spread, destroying the ossicles, tympanic membrane and other parts of the ear. They appear on the pars flaccida and pars tensa sections of the tympanic membrane. A cholesteatoma can occur when a part of a perforated tympanic membrane is pushed back into the middle ear space, debris and skin cells can build up forming a growth.... [tags: Cholesteatoma Diagnosis]
1166 words (3.3 pages)
- Genetic testing, also known as screening, is a rapidly advancing new scientific field that can potentially revolutionize not only the world of medicine, but many aspects of our lives. Genetic screening is the sequencing of human DNA in order to discover genetic differences, anomalies, or mutations that may prove pathological. As genetic screening becomes more advanced and easily accessible, it presents society with difficult questions that must be asked about the boundaries of science and to what degree we are allowed to tamper with the human genome.... [tags: prenatal genetic screening, diagnosis]
1504 words (4.3 pages)
- According to Ambrose and Yairi, the purpose of this report is to provide such a reference. To develop, refine, and answer theoretical questions concerning stuttering characteristics at early stages of the disorder, and to provide a basis for clinical needs of differential diagnosis of stuttering from normal disfluency, their objective was to obtain data from sample size, representing population variability of very early stuttering for preschool-age children. Ambrose and Yairi have questions in addition to providing normative data for dysfluency types for early stuttering and normal disfluencies, regarding possible gender and discrete age differences with the preschool range were addressed.... [tags: Differential Diagnosis]
987 words (2.8 pages)
- Testing is important because it is one of the ways to evaluate our performance in school as well as in regular activities such as obtaining a drivers license, employment etc, but it can create high levels of anxiety to the test taker. Stress is usually a result of misconception of what is on the test, as well as the preparation of the test taker. In order to have a successful test taking experience, it is important to implement test taking strategies. We will cover a few to help you have a positive testing experience.... [tags: Testing, ]
451 words (1.3 pages)
- CHIEF COMPLAINT: A 45-year-old female with one month unilateral paroxysmal left sided headaches and sharp and shooting pain in back of head up to the top of skull referring into face, back of eyes and ears causing photophobia and nausea. Associated neck pain and discomfort with occasional muscle spasms and paraesthesia, dysaesthesia and reduced sensation of the scalp region . HISTORY OF PRESENT ILLNESS: Frequent migraine headaches but recently, the character of headache has changed from a pulsating throbbing pain to a burning, aching and shooting type .... [tags: Medical Diagnosis]
2392 words (6.8 pages)