The College of Optometrists

I know this sounds like a silly Q but say if in a diabetic u c dot/blot haems, MA's, exudates with say 2 or 3 CWS but no IRMA or venous beading or looping - how do u differentiate that between moderate background retinopathy and early pre-proliferative with the no. of CWS?

I wouldn't say it's a silly question at all, and I don't know the answer!! I supect even ophthalmologists would disagree on the exact classification of retinopathy, and the criteria used for diabetic screening varies in different areas. As I understand it, CWS are considered much less significant now than the used to be, and I suspect that counting CWS is not of much benefit.

Up to date classification methods are more concerned with haems, MAs exudates, venous beading/looping, and IRMAs. It also seems to be more common to consider the retina in four separate quadrants, and grade each separately, with more cause for concern if there is significant retinopathy in 2 or more quadrants.

Lisa

Also important is to think about how close these things are to the macular, 2 CWS and a few haemorrhages in the periphery is very different to ones near the macular. Also think about if the vision is affected. Remember for this exam you must demonstrate that you are safe to practice, but what the examiner does not want to hear is that you will send everthing to the HES. Go on what you do in practice and what your local health authority guide lines are. Also rememeber that you must send a GP report after seening all diabetic px.