What Is a Diabetic Eye Exam?

What Is a Diabetic Eye Exam?

People with diabetes are susceptible to diabetic damage to their eyes, and therefore they require a special eye exam which will check all necessary aspects of the health of their eyes and eyesight.

Diabetes can cause serious damage to the eyes and therefore it’s essential for all people with this condition to go for an in-depth eye exam once a year. Some diabetics, such as women who are pregnant and have diabetes, will be advised to go for more frequent eye exams. A diabetic eye exam is more thorough than a regular eye exam and involves screening for characteristic harm that diabetes can cause to the eyes. If you or a loved one has diabetes, we recommend scheduling an appointment to have your eyes checked by a professional. If you have diabetes and experience sudden vision changes, please come see the eye doctor immediately to ensure that the proper diagnosis and treatment can be provided when necessary.

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What Does a Diabetic Eye Exam Involve?

Each person's condition is unique and therefore the length and components of a diabetic eye exam depends on what the eye doctor feels is important for your eye health. One who has recently been diagnosed with diabetes will have a different eye exam than a person who has had diabetes for a very long time and has already begun to show signs of diabetic retinopathy. Someone who has already been diagnosed with diabetic retinopathy will most likely have a longer eye exam which could also include treatment in the office provided by your eye doctor.

A diabetic eye exam includes tests which check for:

  • Changes in vision
  • Diabetic retinopathy - changes at the back of the eyes due to diabetes
  • Diabetic macular edema - when leaking fluids cause swelling of the macula which is the part of the retina responsible for central vision
  • Cataract
  • Glaucoma

What to Expect at the Diabetic Eye Exam

The eye exam involves various different steps detailed below. It begins with your eye doctor having a conversation with you about your diabetes and overall health. Your vision will be checked. The diabetic eye exam includes pupil dilation and proper checking of the health of your eyes using different kinds of methods and instruments. 

Medical History

Your eye doctor will want to hear all about your diabetes and medical background. It is important to share which type of diabetes you have and when you were diagnosed. The eye doctor will ask for details on the medications you take and what you do to manage your diabetes. Any other medical information including eye diseases in first degree relatives is also important to share. Please tell your eyecare provider if you have any eye symptoms or have noticed any changes in your vision.

Visual acuity

The eye chart will be used by either your eye doctor or an assistant to check your visual acuity. Your vision can be affected by diabetes and therefore it's important to check how well you're able to see at each visit in order to monitor for any changes. If your clarity of vision decreased, a new prescription for glasses may be given after doing a part of the eye exam known as refraction which determines the best optical correction for you. It’s important to note that the most accurate prescription can be given when your blood sugar has been under control for at least a week prior to your appointment.

Pupil dilation

Pupil dilation is a crucial portion of the diabetic eye exam because it makes the pupils much wider than usual using eye drops. This enables your eye doctor to properly check the back of your eye for any possible damage to the retina, which is the light-sensitive layer of the back of the eye. Diabetic retinopathy is what causes damage to the retina so it's essential for the back of the eye to be properly monitored at each eye exam.

The eye doctor or an assistant will put drops in your eyes to make the pupils larger. This will take effect around twenty minutes after being administered. Usually your pupils will continue to be dilated for approximately two to three hours. We recommend bringing dark sunglasses and to arrange proper transportation for after the appointment to avoid driving with blurry vision due to your dilated pupils.

Fundoscopy

After your pupils have been dilated, the eye doctor will check the back of your eyes and this is known as fundoscopy. There are various signs of diabetic retinopathy and its complications that the eye doctor will look for, such as:

  • Abnormality in the blood vessels
  • Any type of swelling or blood in the retina
  • Fatty deposits
  • Formation of some kind of scar tissue
  • Growth of new unstable blood vessels
  • Detachment of the retina
  • Problems with the optic nerve

There are various tools the eye doctor can choose from, such as hand-held instruments or a special microscope, in order to achieve a clear view of the back of your eyes. There is also incredible technology nowadays which allows for a high-resolution photograph to be taken of the back of your eye. This picture can be shown to you on a big screen which allows your eye doctor to show you any changes taking place in your retina. Also, these photographs are stored in your file so that it can be compared with the results at your future appointments. 

Fluorescein Angiography

A special dye, called fluorescein, is injected in the arm and travels through the bloodstream to your eyes. A picture is taken in which the fluorescein highlights any abnormalities in your eye’s blood vessels, ensuring an accurate diagnosis.

Optical Coherence Tomography (OCT)

OCT is used for imaging of the back of the eye. It shows the different layers of the retina and any atypical fluid or other abnormalities can be detected. OCT is also used to track the effects of treatment.

Glaucoma testing

Diabetic retinopathy can cause added pressure in your eye which could lead to glaucoma. Your eye doctor may examine your optic nerve during fundoscopy because it is directly related to glaucoma. Also, your eye pressure will be measured in order to screen for this condition.

What to Expect at the Diabetic Eye Exam
Diagnosis of Diabetic Retinopathy

Diagnosis of Diabetic Retinopathy

Once the entire diabetic eye exam is complete and the eye doctor has a full picture of your eye health and diabetic condition, a diagnosis can be provided. Based on this, your eye doctor will recommend any preventative measures that can be taken to avoid damage and where necessary, various treatment methods will be discussed. Certain medicine and procedures can be administered by your eye doctor in his office. Please speak to your eye doctor about prevention and treatment possibilities.

Diagnosis of Diabetic Retinopathy

Treatment

Treatment for diabetic retinopathy usually depends on the type and the severity of the condition. Controlling your blood sugar and blood pressure is recommended at all stages of diabetic retinopathy as it can help prevent and even reverse damage to your vision.   

In early diabetic retinopathy, treatment may not be needed. Consistent monitoring will be done by an eye doctor to ensure early detection of any visual change or need for treatment. 

If there is damage to your eyes that requires treatment, as is seen in the case of advanced diabetic retinopathy, there are various methods available. Some procedures and medicine can be administered by your eye doctor in his office. Some treatment options include: 

  • Injected medicine: There are various medications that are injected in the eye after the eye is numbed with anesthetic drops to minimize any pain. Steroid injections could be used to treat macular edema, which is swelling of the part of the retina that is responsible for central vision. There is also an injection called anti-VEGF which blocks the protein that is responsible for forming harmful unwanted new blood vessels that form in advanced diabetic retinopathy.
  • Laser treatment: There are various laser procedures used to stop the leakage of fluid or blood from the eye. This method is also used to shrink the blood vessels that are abnormal. 
  • Surgery: There is a procedure called vitrectomy which is sometimes recommended for advanced diabetic retinopathy in order to remove unwanted fluid and scars from the back of the eye.

Common Questions

It is highly recommended for people with diabetes to get an annual special eye exam for diabetics, unless advised for even more frequent check ups. Pregnancy can exacerbate symptoms of diabetic retinopathy and therefore women who are planning to get pregnant are advised to schedule an appointment with the eye doctor prior to pregnancy. A diabetic eye exam should be scheduled during the first trimester and at that appointment your eye doctor will assess how often you should come in to be checked moving forward. Consistent diabetic eye exams can ensure early detection and proper protection of your eyes and your vision.
A diabetic eye exam is very thorough and caters to proper monitoring of characteristic changes in the eyes. The appointment will begin with the eye doctor asking you for a comprehensive medical history, including details of your diabetic condition. Your vision will be checked for any changes. A diabetic eye exam includes dilation of the pupils to ensure that the eye doctor can efficiently monitor the health of your eye. The back of your eye, specifically the retina which is the nerve layer, will be checked using various methods and instruments. Certain imaging technology can be used to help diagnose any changes in your eyes. When necessary, various treatment methods will be recommended and even possibly provided at this appointment. It’s important to schedule a diabetic eye exam so that your eye doctor can provide the care you need to manage how diabetes affects your eyes.
What Is a Diabetic Eye Exam?
Dr. Wernick cartoon

Summary

Regardless if you’ve just been diagnosed with diabetes or if you’ve had it for a few decades and already received treatment for diabetic retinopathy, consistent eye exams are so important to preserve optimal vision. If you have diabetes, please schedule an appointment to allow our professional eyecare providers to guide you on your journey of maintaining proper eye health.

Testimonials


  • At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


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  • Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


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  • Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


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  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Peter G.

  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Kinkie F.

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