Jump to comment:
- Page navigation anchor for RE: Vision Loss as a Presenting Symptom of Type II Diabetes MellitusRE: Vision Loss as a Presenting Symptom of Type II Diabetes Mellitus
We read the article on sight-threatening diabetic eye disease with interest, and would like to report an unusual case of undiagnosed type II diabetes mellitus presenting as visual loss.
Case: A 41-year-old kennel owner presented with a two-day history of decreased vision and floaters bilaterally. Visual acuity was 6/18-2 in the left eye and 6/60 in the right. Dilated fundus examination showed bilateral vitreous haemorrhages, with neovascularisation at the disc and elsewhere, and tractional retinal detachments. Non-fasting pinprick blood glucose was 20.3mmol/L and blood pressure was 140/100.
The patient denied weight loss (BMI 18) or polydipsia, although detailed questioning revealed a 20-year history of approximately five litres of fluid intake daily, predominantly sugary drinks. Three years before, he experienced slurred speech and pins and needles in his right arm, which was attributed to a viral infection and no further investigations were undertaken. Following his ophthalmology attendance, he was formally diagnosed with type II diabetes mellitus (fasting blood glucose 21.5mmol/L, HbA1c 112mmol/mol, negative anti-GAD antibodies and anti-IA-2 antibodies). Oral hypoglycaemics were commenced.
He underwent urgent bilateral pan-retinal photocoagulation, then sequential vitrectomies with membrane dissection, endolaser, and gas tamponade. Visual acuity at the last clinic visit was 6/9 in the left and 6/36 in the right, attributable to diab...
Show MoreCompeting Interests: None declared.