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Diabetic Eye Exams: How They’re Different & Why They’re Important

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Close up of an eye with diabetes

When you have diabetes, many different aspects will change in your life. In some cases, you have to be more aware than ever before about what you eat and even how you exercise. However, some people may not know that diabetes can have a considerable impact on your ocular health.

People with type 1 and type 2 diabetes have a higher risk of eye complications and eye disease. Because of the increased risk, your optometrist will likely recommend that you have an in-depth, diabetic eye exam at least once per year. In addition to managing your blood sugar levels, regular eye exams are one of the best ways to prevent vision loss caused by diabetes. 

Why Should You Have an Eye Exam When You Have Diabetes?

The number one reason you should have an eye exam, whether you have diabetes or not, is to monitor your ocular health. Eye diseases can develop over the years without showing any signs or symptoms, and if they are allowed to, they can eventually lead to permanent and sometimes sudden vision loss.

When you have diabetes, this can amplify the risk of developing these diseases, including some that are exclusive to diabetes itself. Below are some of the most common diseases and conditions you are at risk of developing if you have diabetes.

Diabetic Retinopathy

Diabetic retinopathy is a disease that can occur when higher sugar levels in your blood (caused by diabetes) damages the blood vessels in your retina. As a result, your retina responds by creating new, tiny, and delicate blood vessels to help provide your retina with the oxygen it needs.

However, because these new vessels are fragile, they can end up breaking, leaking blood and other fluids into your retina and causing vision loss.

Diabetic Macular Edema

Diabetic macular edema can occur when diabetic retinopathy isn’t addressed. The fluids that leak from the delicate blood vessels developed with diabetic retinopathy can eventually find their way under your macula, damaging your central vision.

Cataracts

Cataracts are a common eye condition that occurs when your clear crystalline lens becomes more rigid and opaque, resulting in a milky or cloudy appearance that can impair your vision.

Cataracts generally develop as a result of ageing, but diabetes can increase your chances of developing cataracts. Your optometrist may choose to manage your symptoms using specialty frames and lenses, but in some cases, you may need to have cataract surgery to remove the cataract and clear your vision.

Open-Angle Glaucoma

Open-angle glaucoma is the most common form of glaucoma patients experience around the globe, and diabetes can nearly double your risk of developing this disease.

Open-angle glaucoma happens when there is an increase in intraocular pressure, which is the pressure inside your eye. An increase in intraocular pressure can occur if your eye is producing too much fluid or if your eye doesn’t drain fluid fast enough. As the fluid accumulates, the increased pressure damages your optic nerve and leads to vision loss. 

Man with diabetes getting an eye exam

How Are Diabetic Eye Exams Different?

A comprehensive eye exam is your first step to monitoring your eye health and detecting any possible issues that could permanently damage your vision. When you have diabetes, this is especially true.

The Canadian Association of Optometrists recommends people with diabetes to have annual eye exams to help monitor your eye health. Depending on your eye health, your optometrist may recommend more frequent eye exams.

If you have diabetes, we will use a variety of different tools during your eye exam.

Optos Optomap

Optomap imaging is a type of laser scanning technology and captures an ultra-widefield image of your retina. This can help detect any issues that could develop in your peripheral vision before you start noticing symptoms yourself.

OCT Scans

OCT (optical coherence tomography) scans are a non-invasive imaging technique optometrists can use to capture highly-detailed cross-sectional pictures of your retina. OCT scans can be compared to an ultrasound, but instead of using sound, OCTs use light to create their images.

Humphreys Visual Field

Your visual field is how wide of an area you can see. When you have an eye disease, like glaucoma or diabetic retinopathy, your visual field can decrease. In some cases, you may not even notice it.

The Humphreys visual field is a device we use to assess your visual field and works by having you focus on a single blinking light while other lights blink around your peripheral vision. Your optometrist can then assess your visual field by how you respond to those peripheral lights.

Dilated Fundus Examination

A dilated fundus examination gives your optometrist a more complete view of your retina, including the far periphery. Patients with diabetes should have a dilated fundus exam at least once per year to check for disease in the retina like diabetic retinopathy.

During the dilated fundus exam, your optometrist will first dilate your eyes using eye drops. Then, your optometrist will use an ophthalmoscope and a slit lamp to examine the retina and the structures in the back of your eye.

Combined with the above diagnostic tools, a dilated fundus examination can give your optometrist insight into your eye health, allowing for the diagnosis, treatment, and management of diabetic eye disease. 

Written by Dr. Asim Prasad

Dr. Asim Prasad is a native Calgarian who earned his Bachelor’s of Science degree in Vision Science and Doctor of Optometry degree from Nova Southeastern University in Ft. Lauderdale, Florida in 2008. Before becoming an optometrist, Dr. Prasad earned a bachelor’s degree in Environmental Science from the University of Alberta. After working in the environmental science industry for a short time, Dr. Prasad decided to pursue his true passion: optometry.
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