A 45 year old type1 diabetes mellitus patient had an annual checkup. Ophthalmoscopy showed dot and blot hemorrhage + hard exudate and multiple cotton wool spots. What is the next step in management?

The key is D. Non-urgent referral to ophthalmologist. [Controlling diabetes and maintaining the

HbA1c level in the 6-7% range are the goals in the optimal management of diabetes and diabetic

retinopathy. If the levels are maintained, then the progression of diabetic retinopathy is reduced

substantially. Dot and blot hemorrhage + hard exudate and multiple cotton wool spots indicate this is

pre-proliferative retinopathy. So non-urgent referral to ophthalmologist should be done. If proliferative

retinopathy (with neovascularization) urgent referral is indicated].