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Diabetic Eye Disease (cont.)

When to seek medical care for diabetic eye disease

Even if the person is not experiencing any symptoms due to diabetes, the person should have an annual eye examination by an ophthalmologist (a medical doctor who specializes in eye disease and eye surgery). If the ophthalmologist notices any significant signs of diabetic eye disease or if the person requires treatment, exams may need to be scheduled more frequently than annually.

If the person notes any significant changes in vision other than a mild temporary blurring, they should contact an ophthalmologist immediately.

Questions to ask the doctor about diabetes and eye problems

  • Are there any signs of permanent damage to my eyes from diabetes?
  • Is there any significant loss of vision? If so, is this loss of vision permanent?
  • Are there any signs of cataracts or glaucoma?
  • Do I need any treatment at this time for any problems with my eyes?
  • How often do I need to be examined?

Which specialties of doctors treat diabetic eye disease?

Ophthalmology is the specialty of medicine that deals with diagnosis and treatment of eye disease. The ophthalmologist is the appropriate person to both diagnose and treat diabetic eye disease. Some ophthalmologists limit their practice to diseases of the retina. A general ophthalmologist can decide whether or not the specific patient requires and evaluation by a subspecialist in retinal disease. People with diabetes also will be cared for by their family doctor or internal medicine specialist and other subspecialists as needed.

How is diabetic eye disease diagnosed?

During the eye examination, the ophthalmologist performs the following tests:

  • Visual acuity, which is the level of detail a person can see, is checked. If the patient's visual acuity is not 20/20, testing may include refraction to determine if glasses will improve vision.
  • The patient's visual field, which is the area (or "field") in which a person can see other people and objects, is also checked.
  • The front portions of each eye is examined using a special microscope, called a slit lamp, to check for cataracts and other abnormalities.
  • Tonometry is a method used to measure the pressure inside the eye. If the pressure is increased, it may indicate glaucoma.
    • If signs of glaucoma are noted, a formal, computerized visual field examination may be performed.
    • Visual field testing checks the peripheral (or side) vision, typically by using an automated visual field machine. This test is done to rule out any visual field defects due to glaucoma.
  • The ophthalmologist examines the patient's retina to check for diabetic retinopathy; this requires dilation of the pupils with eye drops to ensure an adequate examination of the retina.
    • If significant signs of diabetic retinopathy are noted, a fluorescein angiogram may be done to help show the extent of damage done to the retinal blood vessels and to help guide treatment.
    • During a fluorescein angiogram, a yellow dye is injected into the blood vessels of the hand or the arm; this dye travels all over the body through the blood vessels, and film or digital photographs are taken as the dye travels through the blood vessels in the retina.
    • Where the blood vessels in the retina are damaged, the dye may leak out of the blood vessels. This leakage and its location are shown on the photographs.
  • Another test that may be performed in patients with diabetic macular edema is and optical coherence tomography (OCT). This is a painless quick method of evaluating the retina using laser light to image the retinal layers and measure the retinal thickness.
Medically Reviewed by a Doctor on 6/13/2016

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Read What Your Physician is Reading on Medscape

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Over the last several decades, there have been a few large-scale trials that have influenced the management of diabetic complications in the eye.

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