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The patient was diagnosed with Type 2 diabetes in 1994 and had undergone bilateral photocoagulation in 2003. He was controlled by a variety of medications. He did not smoke and had no history of glaucoma. He was diagnosed with hypertension in 2002 and takes irbersartan (an angiotensin II receptor antagonist), but openly admits to being less than compliant with this.Pinhole acuities were R 6/18 L 6/36.
The fundus photos clearly show extensive bilateral disc oedema with cotton-wool spots and flame haemorrhages indicative of malignant hypertension.
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