Snap Shot A 47-year-old diabetic male presents with a gradual decrease in vision. On retinal exam, dot-blot hemorrhages, neovascularization, and microaneurysms are noted. Introduction Most common cause of blindness < 50 years Result of vascular damage secondary to glucose-mediated structural changes There are two types proliferative result of vessel growth in the retina non-proliferative result of ischemic and edema damage to the retina Presentation Symptoms gradual and painless vision loss Physical exam dot-blot retinal hemorrhages microaneurysms (non-proliferative) neovascularization (proliferative) Treatment Proliferative medical VEGF inhibitors (bevacizumab) surgical pan retina laser treatment tight glucose control Nonproliferative surgical focal retina laser treatment tight glucose control