Colour fundus photograph of the right eye of a 55-year-old male with 15 years of type 2 diabetes and an HbA1c of 9.4%. The image shows features of severe non-proliferative diabetic retinopathy (NPDR) per the 4-2-1 rule — deep-blot haemorrhages in all four quadrants, venous beading in two quadrants, and IRMA in one.
OCT (see linked case) confirmed centre-involved diabetic macular oedema. The patient was started on intravitreal ranibizumab (loading × 3 months), tight glycaemic control, and referred to the physician for lipid and BP optimisation.
Referral pathway from Purvanchal: primary-care physicians in Chandauli, Mirzapur, Ghazipur and Jaunpur are advised to refer any diabetic with HbA1c > 8 or duration > 10 years for a dilated retinal exam annually — the earlier the referral, the better the vision preserved.
Further reading & references
This article is for patient education. It is not a substitute for personalised medical advice, examination or diagnosis. If you have symptoms discussed here, please book an in-person consultation with a qualified ophthalmologist.