Diabetes and the Eye

If you have diabetes, a yearly dilated eye exam is one of the most valuable things you can do to protect your sight. Diabetes damages the tiny blood vessels in the retina long before you notice any change in your vision, a condition called diabetic retinopathy. It affects about one in four people with diabetes, roughly 9.6 million Americans, and it is the leading cause of blindness in working age adults.

The encouraging part is that more than 90 percent of diabetes related vision loss can be prevented when it is found and treated early. That is what this exam is built to do.

We check for diabetic retinopathy in every comprehensive eye exam we perform. A diabetic eye exam is not a different kind of exam. It is a comprehensive eye health examination with additional testing focused on the retina and its blood vessels, looking for the earliest signs of diabetic change: small areas of bleeding, swelling, and leaking vessels. The aim is to find damage long before it reaches your sight.

Diabetic retinopathy usually has no symptoms in its early and most treatable stages. By the time vision changes are noticeable, the disease is often well advanced. The exam is not about how your eyes feel, it is about catching silent damage while treatment still works well.

Beyond the standard comprehensive examination, these are the additional tests we perform for patients with diabetes, so that your retina is documented and can be compared year to year.

Dilating drops widen the pupil so the retina can be examined right out to its edges, where early diabetic changes often appear first.

Our Optovue OCT images the layers of the retina in cross section. It detects diabetic macular edema, the retinal swelling that is the most common cause of vision loss in diabetes, at a stage where it cannot be seen on a standard examination and before it affects your sight.

Our DRS fundus camera photographs the back of the eye and creates a permanent record. We use red and green filters to help locate blood leakage and vascular changes that are harder to see in a standard color image. With diabetes the year to year comparison is the point: small changes between images are what tell us whether your eyes are stable or whether your diabetes care needs adjusting.

The same examination shows hypertensive retinopathy, the damage raised blood pressure causes to the same small vessels. Diabetes and high blood pressure often occur together and compound each other, so we look for both.

Everyone with diabetes should have a dilated eye exam at least once a year, even when vision seems perfectly fine. If we find any diabetic retinopathy we will want to see you more often so we can watch it closely.

A diabetic eye exam is a medical exam, so it is generally billed to your medical health insurance rather than to a routine vision plan, because it is evaluating and monitoring a medical condition. Coverage varies between plans, and our staff can confirm your specific benefits before your visit.

At least once a year, and more often if any diabetic retinopathy has already been found. The annual dilated exam is the standard recommendation for people with diabetes, whether type 1 or type 2, and it applies even when your vision seems completely normal.

Yes, and that is the central reason the exam matters. Diabetic retinopathy develops silently and typically causes no symptoms until it is advanced. Damage to the retinal blood vessels can be well established while your vision still feels entirely normal.

It is a comprehensive exam with an added focus on the retina and its blood vessels, usually with dilation and retinal imaging, and it is billed as a medical visit rather than a routine vision check.

Yes. Treatment is far more effective the earlier it starts, which is why annual screening matters so much. Options include injections, laser treatment and surgery depending on the stage, alongside blood sugar and blood pressure control. More than 90 percent of diabetes related vision loss is preventable with early detection.

It helps a great deal. Good blood sugar control, along with managing blood pressure and cholesterol, meaningfully lowers the risk of diabetic retinopathy developing and slows it where it already exists. It reduces risk rather than removing it, so annual screening is still needed.