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The Diabetic Eye Exam

Eye with cataracts due to diabetes

As National Diabetes Awareness Month comes to a close, the doctors at Coastal Vision would like to remind everyone of the health risks diabetes poses to your eyesight. Our doctors see many patients who are struggling with diabetes related vision issues, or are at risk to develop them.

To give a little more insight into the diabetic eye exam, Dr. Beach has shared what he covers to address his patient’s needs:

5 Questions I must answer during the diabetic eye exam

As soon as I see that a patient has a history of diabetes, I make a mental list of questions that must be answered by the time the exam is over. The risk of diabetes related eye disease is very high, so my attention to any small and early changes is extremely important.

Below of are five of those questions I must answer before the end of a diabetic eye exam:

1. What is the historical and present status of blood sugar monitoring and control?

Health history is very important to understanding the depth of a patient’s diabetic status. Duration of disease, severity of blood sugar levels, and success in monitoring and controlling levels are all key factors in evaluating the risk for eye-related complications of diabetes. The longer a patient has diabetes, even if under control, the greater the risk for diabetic retinopathy. Poorly controlled blood sugar levels are important because that poses risk for glasses prescription fluctuations, as well as retinopathy. History is the base on which everything else builds in the diabetic eye exam.

2. Are there any symptoms or physical sign of dry eye disease?

There’s a very high correlation between diabetes and dry eye disease. Dryness can cause a range of symptoms from mild discomfort, to severe discomfort and vision instability. The good news is that there are methods and medications to alleviate this condition. It’s not something a patient just has to accept as normal, and addressing it is important.

3. Are there any signs of cataracts?

Cataracts are a clouding of the natural intraocular lens inside the eye. There are natural cataracts that most of us develop in our 60’s and 70’s. But, there are also diabetic cataracts that can occur at much younger ages and can be more debilitating to a person’s vision. Blurry vision, cloudy vision, and increased night glare can be symptoms of diabetic cataracts. Depending on the severity of the cataracts, referral to a cataract surgeon may be indicated.

4. Are there any indications of glaucoma?

Some studies have shown an increased risk of glaucoma in patients with diabetes. Glaucoma is a serious disease in which the optic nerve, which carries vision signals to the brain, is damaged. Glaucoma typically does not cause any symptoms such as pain or vision loss in the early to moderate stages. However, if glaucoma is not diagnosed and treated early it can progress to permanent blindness. The eye doctor’s job is to make sure it never gets to that point, which is why I want to look very closely for any signs of glaucoma in every diabetic patient.

5. Is there any diabetic retinopathy?

This is the big question and is at the core of every diabetic eye exam. Diabetic retinopathy is the number one cause of irreversible vision loss in the United States. Diabetic retinopathy is essentially bleeding in the retina, which is the important tissue on the inside lining of the eye. If small hemorrhages in the retina can cause vision reduction. More severe forms of diabetic retinopathy include swelling in central vision areas of the retina as well as destructive blood vessel growth which can lead to retinal detachments. Again, early detection is the key to effective treatment and prevention of permanent blindness. And, in the early stages of diabetic retinopathy there may be no symptoms experienced by the patient.

These are just 5 of the many questions I must answer before I’ve completed a diabetic eye exam. These are also 5 very important reasons why diabetic must have a yearly, dilated eye examination. This holds true for all levels of diabetes, controlled or uncontrolled. If we could get more diabetics to stick with yearly exams, there is a great likelihood we could reduce the long-term impacts of the disease on the eyes through early detection and treatment of diabetes-related eye conditions.

If you think you might be at risk for diabetes related eye complications, please request an appointment here so our doctors may help determine proper treatment.