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Diabetic Eye Exam

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​Diabetic retinopathy is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive linning at the back of the eye.  It is a serious sight-threatening complication of diabetes.

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Diabetic retinopathy is the result of damage to the tiny blood vessels that nourish the retina.  They leak blood and other fluids that cause swelling of retinal tissue and clouding of vision.  The condition usually affects both eyes.  The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness.

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Symptoms of diabetic retinopathy include:

                 Seeing spots of floaters in your field of vision

                         Blurred vision

                         Having a dark or empty spot in the center of your vision

                         Difficulty seeing well at night

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In patients with diabetes, prolonged periods of high blood sugar can lead to the accumulation of fluid in the lens inside the eye that controls eye focusing.  This changes the curvature of the lens and results in the development of symptoms of blurred vision.  The blurring of distance vision as a result of lens swelling will subside once the blood sugar levels are brought under control.  Better control of blood sugar levels in patients with diabetes also slows the onset and progression of diabetic retinopathy.

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Often there are no visual symptoms in the early stages of diabetic retinopathy.  That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive dilated eye examination once a year.  Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy.

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Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include:

 

  • ​ Patient history to determine vision difficulties experienced by the patient, presence of   diabetes, and other general health concerns that may be affecting vision

  • Visual acuity measurements to determine the extent to which central vision has been affected

  • Refraction to determine the need for changes in an eyeglasses prescription​

  • Evaluation of the ocular structures, including the evaluation of the retina through a dilated pupil

  • Measurement of the pressure within the eye​​

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Supplemental testing may include:​

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  • Retinal photography or tomography to document current status of the retina

  • Fundus Photography: This specialized non-invasive digital camera contains a high power lens that captures a photograph of the back of the eye. Because of this ability, fundus photography is able to document and sometimes diagnose particular eye conditions. The most common structures captured through fundus photography are the optic nerve, macula, and the main retinal blood vessels. Fundus photos are quick, painless, and can provide the doctor with information to diagnose current eye issues as well as a foundation to determine change over time.

 

Risk factors for diabetic retinopathy include:

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  • Diabetes - people with Type 1 or Type 2 diabetes are at risk for the developement of diabetic retinopathy. The longer a person has diabetes, the more likely they are to develop diabetic retinopathy, particularly if diabetes is poorly controlled.

  • Race - Hispanic and African Americans are at greater risk for developing diabetic retinopathy.

  • Medical conditions - persons with other medical conditions such as high blood pressure and high cholesterol are at greater risk.

  • Pregnancy - pregnant women face a higher risk for developing diabetes and diabetic retinopathy.  If gestational diabetes develops, the patient is at much higher risk of developing diabetes as they age.

 

 

Information courtesy of the American Optometry Association

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