eyes looking from side to side

Keep An Eye On: Your Annual Diabetic Eye Exam

At my initial counseling session with each person with diabetes, I have a checklist I review to make sure my patient is on target/up to date with their diabetes-specific medical exams. Getting targeted exams are preventative measures to stay ahead of any diabetes-related complications associated with having persistently elevated blood sugar readings. In this post, I focus on the reason behind having a routine eye exam.

Vision problems with type 2 diabetes

All people with diabetes have an increased risk for diabetic eye disease, including glaucoma, cataracts, diabetic retinopathy and associated diabetic macular edema. Like all “complications of diabetes,” vision-related complications are associated with long term high blood glucose levels, and it’s why we focus so closely on controlling blood glucose levels with medication, diet and exercise.

With diabetic retinopathy – the leading cause of blindness among working age adults – persistently high blood glucose levels damage and weaken the small blood vessels that supply oxygen and nutrients to our retina. These weakened vessels can leak blood and fluids into the eye, and eventually lose their ability to transport blood and fluid to the retina causing a “domino effect” of new blood vessels growing, weakening and turning to scar tissue.

Prevention, delay and treatment of vision problems

While diabetic eye disease can be prevented or delayed, it is also treatable. In fact, early detection and treatment of diabetic retinopathy can reduce the risk for blindness by 95%. Note the words EARLY DETECTION. In the early stages of diabetic eye disease, symptoms are not obvious. That is precisely why a diabetes-specific eye exam is so crucial.

What is a diabetic eye exam?

An eye exam for people with diabetes isn’t the same as an exam when you get glasses or contact lenses. A diabetic eye exam will include a dilated eye exam so the ophthalmologist can look in the back of the eye (retina), look for evidence of blood and nerve damage, and look for changes in the lens. If damage is suspected, the exam may include photos enhanced by dye.

When should I start having my eyes examined?

The American Diabetes Association Standards of Care recommends as follows:

  • Patients with type 2 diabetes should have an initial dilated and comprehensive eye exam by an ophthalmologist or optometrist at the time of diabetes diagnosis
  • If there is no evidence of retinopathy for one or more eye annual eye exams and glycemic is well controlled, then exams every 1-2 years may be considered. 
  • If any level of retinopathy is present, subsequent dilated retinal examination should be repeated at least annually. If retinopathy is progressing or sight threatening, then examination will be required more frequently. 

And remember, when your diabetes educator pushes you to schedule that annual eye exam, she/he is “looking out” for your ability to keep looking out.

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