Question

A 56-year-old man with diabetes presents with an intraocular pressure (IOP) of 58 mmHg, visual loss of (20/80), iris neovascularization, corneal edema, and proliferative diabetic retinopathy. After controlling his IOP, what is the next step in management?

1) Perform a comprehensive dilated eye examination
2) Refer to a retinal specialist for evaluation and treatment
3) Start topical antiglaucoma medications
4) Perform optical coherence tomography (OCT) of the retina

Answer 1

The best next step after controlling the intraocular pressure in a patient with advanced diabetic eye disease is to refer them to a retinal specialist for further evaluation and treatment.

Step-by-step explanation:

After controlling the intraocular pressure (IOP) of a 56-year-old man with diabetes, who presents with visual loss and symptoms of advanced glaucoma including iris neovascularization and proliferative diabetic retinopathy, the next step in management should be a referral to a retinal specialist for further evaluation and treatment (option 2). The specialist can provide a comprehensive approach to the patient's retinopathy and potential neovascular glaucoma, which may include procedures like laser photocoagulation or anti-VEGF injections, in conjunction with further glaucoma management.