Guest post by
           Dr. Dylan Belt, OD

Eye Care 108
108 W 2nd Ave.
Franklin, VA 23851

P: 757-562-4321
F: 757-562-3378


Accepting new patients!


Why do I need an eye exam if I have diabetes?

Diabetes is the number one cause of blindness among adults in the United States. Not only can blood sugar fluctuations cause temporary fluctuations in vision, they can cause damage to the small blood vessels of the eye.  This is called diabetic retinopathy.  These blood vessels nourish the retina, the light sensing membrane on the back of the eye.  Damage to these blood vessels may result in reduced blood flow to the retinal tissue and leaking of blood inside the eye. These conditions may result in permanent, irreversible loss of vision that cannot be repaired with glasses, contact lenses, medications, or surgery.  Diabetic changes in the back of the eye can be detected before a person notices any change or loss of vision.  


What is a diabetic eye exam?

A diabetic eye exam must include a thorough evaluation of the inside of the eye using dilating eye drops.  Dilating eye drops increase the size of the pupil to allow the doctor to look inside. Additionally, ultra-wide field retinal photography may be used to document the current condition of the retina and establish a baseline for future monitoring. 


When should I have a diabetic eye exam?

For anyone diagnosed with diabetes, a yearly dilated eye examination is recommended.  If diabetic retinopathy is present, more frequent examinations might be necessary.


What if diabetic retinopathy is found?

Changes in the back of the eye related to diabetes may require additional in office testing and monitoring for progression.  These tests may include the use of a diagnostic laser scan to analyze the central part of the retina, called the macula, for swelling and electroretinography to evaluate for increases in retinal cellular stress.  Because electroretinography tests the function of the retinal cells (cells under stress do not function as well as unstressed cells), electroretinography provides a risk assessment that can be highly predictive of future retinal damage prior to seeing structural changes.  If detected early, these functional changes may be reversed.  As structural damage occurs and causes functional loss, these changes are often permanent and irreversible.  The first line of treatment for any patient with any stage of diabetic retinopathy is to improve blood sugar control and reduce the Ha1c.


When does diabetic retinopathy require a visit with a retina specialist?

A retina specialist is an ophthalmologist (an eye surgeon) who only works with the back of the eye.  Retina specialists see patients who are referred for additional monitoring or treatment.  Typically, patients referred to a retina specialist have severe stages of retinopathy and are at high risk for permanent vision loss.  Treatments provided by retina specialists may include injections of medication into the eye to reduce the leakage of blood into the retina or laser treatments to intentionally scar the peripheral retina to decrease the potential for permanent vision loss.  


Can diabetes be diagnosed during a routine eye examination?

Signs of diabetes can be found during a routine eye exam.  Your eye doctor would not make the diagnosis of diabetes, but instead refer you for lab tests to determine if diabetes is present.  By the time that diabetes related signs and symptoms are found in the eye, damage to the eye is already occurring.  The best way to diagnose diabetes before the eye is affected is by having yearly evaluations with lab testing ordered by a primary care provider.