This is a fundus image of the retina of a woman in her mid 60s with type 2 diabetes who presented with visual disturbances in her left eye (fig 1). She had been diagnosed with diabetes 15 years earlier and had an HbA1c levels consistently above her target range. She had not previously undergone diabetic retinopathy screening. The visual acuity of her left eye had decreased to 20/200 and scattered haemorrhages and exudates were found on funduscopy, with accompanying neovascularisation in the temporal macula (arrow). Initially, the bleeding was confined between the retina and the internal limiting membrane, a membrane that sits between the retina and the vitreous. This resulted in a distinctive boat shaped appearance (*).1bmj;385/may16_10/e077450/F1F1f1Fig 1Haemorrhages confined within the internal limiting membrane are typically less severe and may have a better prognosis than those that breach the membrane into the vitreous cavity.2 These pre-retinal bleeds may resolve spontaneously…
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