Eye Exams for People With Diabetes

Managing your diabetes means being aware of the other health issues you might face because of it. Diabetes -- both type 1 and type 2 -- increases your risk of eye complications over time, and some of those problems could lead to blindness.

Whether it’s minor eye disorders or something more serious, it’s important for people with diabetes to have regular eye exams and screenings, and to manage their diabetes.

Many people with diabetes don’t know that they have the condition. Your eye doctor may see some of the signs of diabetes-related damage during an eye exam. This could be a tip-off that you need to see your doctor to find out if you have diabetes.

How Diabetes Affects Your Eyes

Throughout your body, two of the key problems diabetes can cause are damage to the nerves and blood vessels. Both of those problems can affect your eyes, and your eye exam can help flag any damage.

Diabetes affects the retina, which is at the back of the eye. It turns light signals into electrical signals. Those signals travel through the optic nerve to the brain, which turns the signals into images you see. A part of the retina called the macula lets you see fine details clearly. The macula depends on blood vessels in and behind the retina to keep it working.

Over time, uncontrolled diabetes can damage those blood vessels and cause a condition called diabetic retinopathy. How much of your macular function and vision are affected can vary.

People with diabetes are also more likely to develop glaucoma. The longer you’ve been living with diabetes, the more common this eye condition is. Uncontrolled diabetes is a major risk.

Glaucoma happens when there’s a buildup of pressure in the eye. The extra pressure can damage the optic nerve, causing your vision to slowly get worse. You could eventually lose your vision completely.

How Regular Eye Exams Can Help

To prevent severe vision loss from conditions like diabetic retinopathy, it’s very important that you check with your eye doctor, who can spot signs of this damage to the blood vessels related to the eye.

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If your diabetes is newly diagnosed, get your eyes checked for diabetic retinopathy ASAP. The results of this examination will determine what kind of follow-up screenings or tests that you’ll need to do. Delaying or skipping this first screening could lead to permanent vision loss that was preventable.

Don’t delay it because your vision seems fine. You might not have any symptoms of diabetic retinopathy in the early stages. Those might not show up until the condition is severe. This is why screening right after you find out you have diabetes is so important.

How Often Should You Get an Eye Exam?

Because you have diabetes, you need a comprehensive eye exam every year from an ophthalmologist or optometrist who knows about the eye problems that are a risk with diabetes.

For adults with type 1 diabetes, it’s recommended that you have a dilated eye exam within 5 years of being diagnosed, and then shift to an annual exam.

About 1 in 5 people with type 2 diabetes have some eye problems when they’re diagnosed. So getting an eye exam right after your type 2 diagnosis is key. After that, you would get your eyes screened every year. If your results are normal, some eye doctors might suggest moving your exams to every 2 or 3 years.

For women with diabetes who become pregnant, you’ll need an eye exam during your first trimester. You’ll also need to be checked again a year after you give birth. Talk to your eye doctor about the effects pregnancy can have on your eyes.

What to Expect at Your Eye Exam

First thing to know about this exam is, it’s painless and fairly easy. A comprehensive eye exam typically includes the following tests:

  • Visual acuity test. This checks how clearly you see. Your doctor will ask you to read letters that are up close and then far away.
  • Visual field test. This checks your how well you can see objects that are off to the sides without moving your eyes.
  • Eye muscle function test. This checks for any problems you might have with the muscles around your eyeballs. Your doctor moves an object, like a pen, around, asking you to follow it with just your eyes.
  • Pupil response test. This checks how light enters your eyes. Your doctor shines a small flashlight into your eyes and watches how your pupils react to it.
  • Tonometry test. This measures the pressure in your eyes by using a machine that blows a puff of air into your eye. Sometimes your doctor might gently touch your eye with a special tool as well. Both methods are painless.
  • Dilation. This lets your eye doctor check for any problems with the inner parts of your eye. Your doctor puts drops in your eyes to make your pupil widen (or dilate), letting more light into your eye. It makes it easier for the doctor to see the retina to check for eye diseases. The drops take 30-60 minutes to work.

The key to staying on top of your eye health is regular and consistent testing -- and keeping your diabetes under control.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on July 17, 2020

Sources

SOURCES:

Peter J. Lowe, MD, ophthalmologist, Retinal Eye Care Associates, Lake Worth and Delray Beach, FL.

Bhavin Shah, behavioural optometrist, Central Vision Opticians, London.

Kellogg Eye Center Michigan: “Anatomy of the Eye.”

American Diabetes Association: “Eye Complications,” “The Diabetes Advisor.”

National Eye Institute: “Get a Dilated Eye Exam.”

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