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What to Expect at Your Diabetic Eye Exam

What to Expect at Your Diabetic Eye Exam

Diabetes is becoming an epidemic in the United States. According to the CDC, some 34.2 million Americans — 10.5% of the population — had diabetes as of 2018. The disease increases blood sugar levels, either because the pancreas doesn’t produce enough insulin to shuttle sugar into the body’s cells, where it’s used for energy Type 1), or because the cells become resistant to insulin’s effects (Type 2).

About 90-95% of cases in adults are Type 2. Risk factors include a poor diet and a sedentary lifestyle, making it the most preventable form.

At Retina Specialists, with five locations around the Dallas, Texas, area, our team of expert ophthalmologists regularly performs diabetic eye exams to evaluate, diagnose, and treat diabetes complications that affect the eyes.

If you have diabetes or are at risk for developing it, here’s why these exams are so important, and what you can expect when you come into our office..

How the eye sees

To understand how diabetes affects your sight, it helps to know how the eye is structured. To do that, let’s follow how light travels. 

Incoming light hits the eye’s surface, which is covered with a tough membrane that’s both clear and curved. Because it’s clear, it lets the light through. The curvature (cornea) focuses that light while protecting the eye.

Next, the light moves through a fluid-filled area called the anterior chamber (filled with aqueous humor), through the pupil, and then through a lens that focuses it more. Finally, it passes through another fluid-filled chamber (the vitreous humor), striking the retina at the back.

The retina converts the focused light into electrical signals and transmits them to the brain through the optic nerve. Your brain decodes the signals to let you “see” the image.

The central 2% of the retina, known as the macula, registers your clear, central vision. It’s fed by blood vessels both in and behind the retina.

What are common diabetic eye complications?

High blood sugar can lead to problems that range from blurry vision to total blindness. That’s why it’s so important to get your eyes checked regularly, to prevent problems before they become severe and hard to treat. Here are some of the most common complications.

Nonproliferative diabetic retinopathy (NPDR)

Diabetic retinopathy is a major cause of blindness; it affects more than one in four American adults living with diabetes.

In its early stages, supporting blood vessels weaken and leak into the retinal tissue. This may also trigger lipids (fats) to deposit on the retina. In later stages of NPDR, the macula may swell, (macular edema), leading to blurred vision.

Proliferative diabetic retinopathy (PDR)

As the retinopathy progresses, some blood vessels close off, starving the macula of oxygen and essential nutrients. This results in new vessels proliferating on the retina’s surface, causing anything from visual floaters (annoying but harmless) to scar tissue buildup to a detached retina and loss of sight.


Glaucoma is a collection of eye conditions, all of which damage the optic nerve. It’s a major cause of lost vision in those over 60 years. High blood sugar levels interfere with proper eye drainage, increasing the pressure inside your eye and leading to nerve damage.

Many forms of glaucoma don’t present any warning signs until they reach an advanced stage. And once your vision’s gone, there’s no way to get it back. That’s another reason why regular diabetic eye exams are so important.


Cataracts occur when the eye’s normally clear lens clouds with debris. Anyone can develop them, and they’re quite common as you get older, but diabetics often develop them earlier, and they get worse faster.

What to expect at your diabetic eye exam

When you come into Retina Specialists for a diabetic eye exam, your ophthalmologist evaluates both your vision and your eye health, just as with a regular comprehensive exam. However, here, he pays special attention to the eye structures that diabetes typically damages. 

To start, the doctor dilates your eyes with eye drops. This allows the pupil to remain open so he can see clearly to the back of your eye using the high magnification of a slit lamp tool. He examines all the tissues, fluid-filled spaces, blood vessels, and nerves. He looks for signs of glaucoma, macula edema or degeneration, retinal problems, and cataracts, and he evaluates your overall eye health.

If you have diabetic retinopathy or any other eye disease, he can begin effective treatment promptly, so the disease doesn’t progress to a more advanced stage that’s harder to treat. And knowing how your diabetes is affecting your eyes allows you to adjust your regimen to forestall future problems.

If you have diabetes and haven’t been to the eye doctor in a while, there’s no time like the present to schedule an evaluation at Retina Specialists. Call us at any of our five Texas offices, or book online with us today.

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