Diabetes-Related Eye Exams

You have almost certainly heard of diabetes, which is one of the most common chronic health conditions in the United States with an estimated 100 million adults currently living with diabetes or pre-diabetes. This metabolic disorder occurs when the body is no longer able to regulate its own blood sugar levels and requires intervention to keep them stable. Most people are aware that diabetes can have serious consequences for our health. However, you may be surprised to learn that it can also influence our vision in several ways. For example, blood sugar changes associated with diabetes can change the focusing power of the internal crystalline lens. This can cause significant changes in your prescription and blurred vision. Diabetes can also affect function of the external eye muscles, which can lead to double vision. However, the most concerning complication involving the eyes is diabetic retinopathy, where diabetes damages the delicate blood vessels in the retina. Without prompt treatment, diabetic retinopathy can cause permanent vision loss. It is for this reason that patients who suffer from diabetes are asked to attend regular diabetic-related eye exams.

What is diabetic retinopathy?

For us to be able to see clearly, our eyes need to be healthy and functioning properly. The most complex component of our eyes is the retina. Found at the very back of the eye, the retina is a patch of light-sensitive cells and interconnected nerves that have the job of converting the light that passes into the eye into messages that are passed up the optic nerve and into our brain. Our brain then receives them and tells us what we can see and how clearly we can see it.

​​​​​​​The retina relies on a continuous supply of blood, which is delivered using a network of tiny blood vessels. Over time, having continuously high blood sugar can damage these blood vessels causing a leak of blood and other fluids into the retina. If this happens, scarring may occur which could compromise the quality of your vision.

Am I at risk of diabetic retinopathy?

Technically, anyone who suffers from diabetes, whether it be Type 1 or Type 2, could be at risk of developing diabetic retinopathy. However, the condition is more likely in certain situations. These include if:

• your blood sugar levels are uncontrolled or poorly controlled

• you have a long history of diabetes

• you have high blood pressure (hypertension)

• you suffer from high cholesterol

• you are pregnant

Regular diabetic-related eye exams will enable your eye doctor to monitor your condition and ensure that any signs of diabetic retinopathy are detected and acted upon immediately.

What to expect from diabetes-related eye exams?

The process of a diabetic eye exam is very simple and straightforward. In fact, in most instances, it is included within the other elements of comprehensive eye exam and you may not even realize that you have had a specific test to check for diabetes-related complications.

Diabetic eye examination is non-invasive. Our office has leading-edge technology to assist the doctor in examining changes in the eyes caused by diabetes. For example, we utilize ultra-widefield digital imaging of the retina in the back of the eye to look for complications such as blood vessel abnormalities, leakage and bleeding in the retina. These changes are called diabetic retinopathy, which is a leading cause of vision loss in the United States. The health of the retina is also a key indicator of overall blood vessel health throughout the body. Digital imaging is a quick, painless procedure that often can be performed without the need to dilate the pupils.

In addition to the images of the back of your eye being taken, you will also be given a visual acuity test. This is where you will be asked to read letters off a chart a short distance away, as well as reading from a card held in front of you. This is an important test of how the nerves in the eye are functioning.

Another test that the doctor may utilize is a detailed 3D scan of the retina with an instrument called an OCT. This quick, non-invasive test helps the doctor look for swelling in the macula (the center part of the retina) caused by diabetes, as well as other diseases such as macular degeneration.

Diabetes causes changes in circulation, which can impact the way our nerves function. We can quickly and objectively measure nerve function in the eye with a small hand-held device. This test, call an electroretinogram (ERG), uses small stick-on sensors on the upper cheek area to non-invasively measure nerve function. This gives the doctor valuable information about the impact of diabetes not just in the eye, but systemically as well.

With these tests, the doctor will have a comprehensive assessment of how diabetes is affecting your eyes and vision. If you are experiencing complications such as diabetic retinopathy, they will discuss the best way to get your condition under control. This could involve a combination of elements, including controlling your diabetes more effectively, taking medications or more invasive treatment to preserve your vision. Your eye doctor will give you more specific information based on your individual circumstances.

If you have further questions about diabetic-related eye exams, please contact our knowledgeable eye care team.