60 YEAR OLD PATIENT WITH UNCONTROLLED SUGARS AND LOSS OF VISION

60 year old female with complaints of uncontrolled sugars since 3 days and decreased vision in left eye since 1 year 

Patient was apparently asymptomatic 3 days  back then She is having uncontrolled sugars .she has come to hospital with loss of vision in  left eye since 1 year 


Past history :
H/o cataract surgery 5 years back
H/o diabetes mellitus since 3 years on medication of glimiperide and metformin 
No h/o hypertension , asthma ,epilepsy 


Personal history :
Married  
Occupation farmer 
Bowel and bladder regular
No known allergies 
No addictions 

Family history:
Not significant with the patient history 


On examination:
Patinet is conscious/coherent/ cooperative 
No pallor /icterus/cyanosis/clubbing/lymphadenopathy 
BP -110/70mmhg
PR-78BPM
RR-16CPM
SPO2-98 ON RA
GRBS-103 mg /dl on admission 

Systemic examination:
CVS - S1 S2 heard
CNS- NAD
RS- BAE + ,NVBS HEARD
P/A - SOFT ,NON TENDER.


Eye examination:
                                   Right                             left 
Visual acuity            CF 3MT pinpoint          HM+
                                  Pupil 3/60
  
Lids                       normal                 puspoint boken
Conjunctiva             quiet                      quiet
Cornea                    arcus                   arcus    
Anterior chamber  NAD                      NAD
Pupil                       oval                         NSRL
Lens                       psuedophakia        HMC
IOP                          9mmhg                 9mmhg
S/S                          patent                   patent
       

Investigations :
RBS - 
27/4/22:
240mg/dl
28/4/22:
11pm -108mg/dl
29/4/22:
2am-94mg/dl
3am-122mg/do


Serology :
HIV, RBS ,HCV -negative





Provisional diagnosis:
Left eye High Myopia cataract 
Uncontrolled sugars

Treatment given : 
Sx: SICS WITH PCIOL FOR CATARACT DONE on 27/4/22
1.TAB TRIPRIDE 1 PO OD
2.E/D CIPROFLOX QID






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