Diabetes and your eyes: why the yearly dilated exam is not optional
Diabetic eye disease has no early symptoms. A yearly dilated exam is how it gets caught while treatment still works.
If you have diabetes, your doctor has probably told you to get your eyes checked every year. Here is why that isn't box-ticking, and what the exam involves.
What diabetes does to the eye
High blood sugar damages small blood vessels, and the retina at the back of the eye is packed with them. Vessels leak, swell, or close off; the eye tries to grow new ones, which are fragile and bleed. This is diabetic retinopathy, the leading cause of new blindness in working-age adults. It typically causes no symptoms at all until it's advanced. By the time vision changes, treatment is harder and some loss may be permanent.
Diabetes also raises the risk of cataracts and glaucoma, and blood-sugar swings can change your glasses prescription temporarily, which is why we ask how your control has been before prescribing new lenses.
What a diabetic eye exam involves
Everything in a regular comprehensive exam, plus a careful look at the retina with your pupils dilated. Dilation drops widen the pupil so Dr. Dolan can see the whole retina, not just the center. He checks for leaking vessels, swelling in the macula (the part that gives you reading vision), and new vessel growth, and compares to previous visits. After the exam we send a report to your primary care doctor or endocrinologist, so your whole team has the same information.
Dilation makes near vision blurry and eyes light-sensitive for three to four hours. Bring sunglasses, and if you're nervous about driving, bring a driver.
How often
- Type 2: a dilated exam at diagnosis, then every year.
- Type 1: within five years of diagnosis, then every year.
- Pregnancy with diabetes: early in pregnancy and as advised, since retinopathy can progress quickly.
- If changes are found: more often, as Dr. Dolan recommends, and referral to a retina specialist if treatment is needed.
What you can do between exams
Blood sugar, blood pressure and cholesterol control all slow retinopathy. So does not smoking. And call the same day if you notice sudden blurring, new floaters, dark spots or a shadow in your vision.
A diabetic eye exam is medical care, billed to your health insurance. To schedule one in Rochester Hills, call (248) 375-0040.
20/20 Vision is an independent optometry practice and designer eyewear boutique at 3110 Walton Blvd, Rochester Hills, MI 48309, serving Rochester Hills, Rochester, Oakland Township, Auburn Hills and Troy since 1980. Eye exams with Dr. David Dolan, OD. In-network with VSP.