A 56 year – old lady presented with a sudden fall in vision in the left eye of 1 day duration. She had history of Diabetes Mellitus for the last 12 years and was under treatment (oral hypoglycemic agents). But her sugar was not under control and fasting blood sugar was 180 mg/dl. On examination her vision in the right eye was 6/9 and left eye was counting fingers 2 meters. Lens showed early cataract in both eyes. Fundus right eye showed many scattered retinal hemorrhages while the left eye fundus could not be seen due to vitreous hemorrhage. Ultrasonography (B scan) left eye showed vitreous echoes corresponding to the hemorrhage and an intact retina.

She was diagnosed to have moderate Non Proliferative Diabetic Retinopathy right eye and Proliferative Diabetic Retinopathy with vitreous hemorrhage in the left eye. For the right eye she was advised regular follow up at 3- 4 months to see for any proliferative changes while for the left eye it was decided to wait for the spontaneous clearing of the hemorrhage.

She was kept at a regular follow up of 2-3 weeks and the hemorrhage was found to be resolving. As the hemorrhage cleared a new vessel tuft was seen at the disc. The visible areas of the retina were treated with Laser in 4 sittings (Pan Retinal Photocoagulation). Four months later the vision left eye was 6/12, vitreous hemorrhage had completely resolved and the new vessels had almost regressed.

A 43 - year old gentleman with history of Diabetes Mellitus of 4 years duration complained of sudden loss of vision in the left eye since 5 days. His sugar was moderately controlled on drugs, with fasting blood sugar being 140 mg/dl. He also had blurred vision in the right since 5-6 months. He had no history of previous retinal examination. Visual acuity in the right eye was 6/24 while left eye had just perception of light. Fundus examination right eye showed thickening of the macula with exudates and new blood vessels at 2 places in the retina. Left eye had no view due to dense vitreous hemorrhage. Ultrasonography left eye showed no retinal traction or detachment.

Patient was diagnosed to have Proliferative Diabetic Retinopathy both eyes with maculopathy in the right eye and vitreous hemorrhage in the left eye. He was advised focal Laser with Pan Retinal Photocoagulation in the right eye and observation in the left eye to look for resolution of vitreous hemorrhage. He underwent laser in the right eye but his left eye vitreous hemorrhage did not clear till 3 months. It was then decided to do surgery (Vitrectomy) in the left eye. During the operation the hemorrhage was removed from the vitreous cavity, few membranes seen on the retina were removed and endolaser done. Post operatively retinal diabetic changes stabilized and patient regained vision of 6/9.

A 51-year old gentleman presented with loss of vision in the right eye of 15 days duration. He was a known diabetic for 15 years and was currently on Insulin therapy for uncontrolled diabetes. He had already undergone 3 Laser sittings in the left eye 10 months back. Six months ago he had a similar episode of sudden fall in vision in the right eye, which had slowly improved over the months but he had not gone back for a retinal examination. Now with the loss of vision of again he had come for an eye check up. On examination his vision in the right eye was perception of light and in the left eye was 6/12. Intraocular pressures were normal. Fundus examination right eye revealed vitreous hemorrhage while left eye showed Laser scars in the retinal midperiphery and no new blood vessels.

Ultrasonography of the right eye showed few vitreous echoes and retina pulled up by a few membranes. He was diagnosed to have Proliferative Diabetic Retinopathy with vitreous hemorrhage and Tractional Retinal Detachment right eye with Proliferative Diabetic Retinopathy status post Pan Retinal Photocoagulation left eye. The patient was advised urgent surgery in the right eye to repair the retinal detachment. He underwent Pars Plana Vitrectomy in the right eye during which the vitreous hemorrhage and the membranes on the retina were removed. The retina was flattened, endolaser done and silicon oil injected to stabilize the retina. Postoperatively retina remained stable and subsequently silicon oil was removed 3 months later by a small surgery. The patient had a vision of 6/18 in the right eye after the surgery and was able to carry out his normal routine satisfactorily.