Diabetes is a systemic condition that affects your entire body, including your eyes. Because high blood sugar can impact the delicate blood vessels in your retina, diabetes can affect your sight in several ways, such as diabetic retinopathy, early-onset cataracts, glaucoma, and glasses prescription. It’s essential to get a diabetic eye exam to prevent permanent vision loss.
At our clinic, we focus on early detection and personalized care to ensure that diabetes doesn’t steal your sight.
What is Diabetic Retinopathy?
Diabetic retinopathy is a serious eye condition that occurs when high blood sugar levels associated with Diabetes cause damage to the blood vessels in the retina (the light-sensitive tissue at the back of the eye).
When the blood vessels in the retina get damaged due to Diabetic Retinopathy, they can swell and leak fluid, or close completely, which prevents blood from passing through. In some cases, abnormal new blood vessels grow on the surface of the retina, which can lead to vision loss if left untreated.
Signs of Diabetic Retinopathy
In the early stages, there are often no symptoms. Even if you have perfect 20/20 vision, damage can still occur. As the condition progresses, you may notice:
- Blurred or fluctuating vision
- Dark spots or “floaters” in your field of vision
- Difficulty seeing colors or washed-out colors
- Dark or empty areas in your vision
- Sudden loss of vision
Understanding Diabetic Retinopathy Stages
The condition is generally categorized into two primary stages: Non-Proliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR).
NPDR (Non-Proliferative Diabetic Retinopathy) is the early stage of diabetic retinopathy. Diabetes can make the blood vessels leak, both fluid and blood. Due to the retinal vessels leaking nutrients before reaching the retinal tissue that needs them, the retina can become ischemic, or oxygen-starved. This can lead to tissue death. Retinal swelling can occur here, as well as swelling in the area of central vision, the macula. Treatment may be needed at this stage.
PDR(Proliferative Diabetic Retinopathy) is the more advanced stage of diabetic eye disease. At this stage, the retina has been so starved of oxygen it begins to grow new blood vessels. This is called Neovascularization. These new vessels are weak, which often causes them to break and bleed. This can cause twisting and scarring of the retina, resulting in vision loss. PDR needs to be treated immediately and is very serious.
NPDR is common but requires careful monitoring. PDR is a medical emergency for your eyes and requires immediate intervention to prevent blindness.
Diabetic Retinopathy Treatment
Diabetic retinopathy treatment is tailored to the severity of the condition:
- Vigilant monitoring for early NPDR, improving your metabolic health, and attending more frequent eye exams
- Injections (Anti-VEGF Therapy) are where medications are injected into the eye to help reduce swelling and stop the growth of abnormal blood vessels
- Laser treatment is used to seal leaking blood vessels or shrink abnormal ones
- Vitrectomy is a surgical procedure to remove blood or scar tissue from the center of the eye in advanced cases
The best treatment is to prevent the onset as much as possible through good control of both blood sugar and blood pressure. It’s important to note that diabetic retinopathy can occur despite excellent blood sugar control
What to Expect During Your Diabetic Eye Exam
A diabetic eye exam is more comprehensive than a standard vision check. We are evaluating the internal health of your eyes. Here is what to expect during your visit:
- Medical history and lifestyle
We’ll talk about your health history, such as:
• How long you have lived with diabetes
• Your most recent A1c levels
• Any recent fluctuations in your vision
• Current medications and how you are managing your blood sugar
- Visual acuity and refraction
We test your vision to see if you need a new prescription for glasses or contacts. However, if your blood sugar is currently high, we may wait to finalize a prescription, as swelling in the lens can cause temporary vision changes.
- Eye pressure and pupil check
We check your intraocular pressure to screen for glaucoma, as people with diabetes are at a higher risk for this condition. We also check how your pupils respond to light to ensure the nerves are functioning correctly. - Dilation
To thoroughly screen for signs of diabetic retinopathy, we’ll dilate your eyes. Medicated drops are used to widen your pupils, allowing the doctor to see the entire retina, the optic nerve, and the blood vessels at the back of the eye.Note: Your vision will be blurry and sensitive to light for a few hours after dilation. We recommend bringing sunglasses and a driver.
- Advanced retinal imaging
To provide the highest level of care, we often use advanced technology to “see” what the human eye cannot:• Optical Coherence Tomography (OCT): A non-invasive scan that provides a cross-section of your retina to check for fluid or swelling (macular edema)
• Digital Retinal Photography: High-resolution photos that allow us to track even the smallest changes in your blood vessels year-over-year
All people with diabetes should have a Diabetic Retinopathy eye exam once a year. More frequent visits may be necessary if Diabetic Retinopathy is present.
Diabetes Eye Care FAQ’s
How often should I have an exam?
Timing is critical for preventing vision loss. Following the American Academy of Ophthalmology standards, your schedule depends on your specific diagnosis.
Type 1 Diabetes
Schedule your first exam soon after your diagnosis and at least once a year after that.
Type 2 Diabetes
You should have an exam at the time of your diagnosis and every year moving forward.
Pregnancy
If you have Type 1 or Type 2 diabetes, receive an exam before conception and again during the second trimester.
Existing Retinopathy
If we detect damage, we may recommend more frequent visits every three to six months to monitor your health.
How can I tell if I have diabetic retinopathy?
Early stages of diabetic retinopathy are asymptomatic. Even some types of retinopathy requiring treatment are without symptoms. Annual eye exams are required to detect diabetic retinopathy early. If diabetic retinopathy is present, a variety of imaging tests are used to monitor the condition and assess the need for treatment.
Where can I get more information about diabetic retinopathy?
Get more information about Diabetes on the American Academy of Ophthalmology or the American Diabetes Association (ADA).
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