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Figure 41-33 Nonproliferative diabetic retinopathy of left eye. There is extensive nonproliferative disease with microaneurysms, hemorrhages, and exudates. Although there is no neovascularization, this patient is at risk of developing proliferative disease.

Diabetic patients should have a baseline eye examination before becoming pregnant or early in the first trimester. On initiation of ophthalmic screening, all diabetic patients should have annual dilated fundus examinations by an ophthalmologist, or sooner if poor diabetic control or visual symptoms develop (AAO, 2007) (SOR A, 1).

Retinal Detachment

Retinal detachment is separation of the retina from its blood supply. It usually follows a tear or hole in the retina. Retinal tears may be caused by trauma or retinal disease, but the cause of most tears is unclear. When the retina is detached, vision is lost from the involved area of the retina. If the macula detaches, irreversible loss of vision may occur unless the detachment is treated within 24 hours. Anatomic reattachment of the retina is successful in up to 90% of cases.

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