What to Expect from Your First Diabetic Eye Exam

Diabetes, a disease that produces high blood sugar levels, is a widespread problem. In 2018, it affected some 34.2 million Americans — roughly 10.5% of the population. 

About 90-95% of cases in adults were Type 2 (insulin resistance rather than little or no insulin production), often the result of a poor diet, excess weight, and a sedentary lifestyle. That makes it the most preventable form of diabetes.

At Omphroy Eye Care, experienced ophthalmologist Luis C. Omphroy, MD, understands the visual complications that diabetes can produce, which is why he provides comprehensive eye exams for diabetics at his Aiea, Hawaii, office. 

These exams focus on preventing eye-related complications from high blood sugar and can help save your sight. If you have diabetes, or if you’re at risk for developing it, here’s why you should get a diabetic eye exam and what you can expect from it.

Eye structure and function

To understand how and why diabetes affects your vision, it helps to understand how the eye is structured. We can do that by following the path light takes. 

Light first hits the cornea, the clear, curved membrane that forms the eye’s surface. The clear area allows the light through. The cornea focuses the light, while at the same time protecting the eye from pathogens and debris.

The focused light heads through the anterior chamber, a fluid-filled space, then it goes through the pupil, and next through a clear lens that refines the focus. Finally, it moves through another fluid-filled chamber, the vitreous, and strikes the retinal tissue at the back of the eyeball.

The retina takes the focused light and converts it into electrical signals, sending them to the brain through the optic nerve. Your brain decodes the signals and allows you to see the image.

The macula is the centermost 2% of the retina, and it’s the area that registers your clear central vision. It’s nourished by blood vessels both in and behind the retina.

Common diabetic eye health problems

High blood sugar levels affect tissues throughout your body, and they can lead to eye problems ranging from blurred vision to total blindness. That’s why you need regular (at least once a year) diabetic eye exams. Some of the major problems affecting the eyes include:

Nonproliferative diabetic retinopathy (NPDR)

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

In its early stages, NPDR can weaken blood vessels so they bulge into the retina or leak blood into the tissue. As a result, lipids (fats) can deposit on the retinal surface, clouding it. In the late stages of NPDR, the macula can swell from the fluid (macular edema), leading to blurred vision.

Proliferative diabetic retinopathy (PDR)

As NDPR progresses, some blood vessels seal themselves off, which prevents oxygen and other nutrients from reaching the macula. 

In response, new vessels proliferate on the retina’s surface. This can cause anything from visual floaters, which are not inherently harmful, to scar tissue to a detached retina, the latter of which can rob you of sight.

Glaucoma

Glaucoma is a collection of eye conditions that increases the pressure within the eye, damages the optic nerve, and prevents it from sending information to the brain. The result is vision loss. Since high blood sugar levels interfere with the eye’s ability to drain properly, it allows for fluid buildup and increased pressure.

Many forms of glaucoma don’t produce any warning signs until they reach an advanced stage, and once you lose vision, you can’t get it back. 

That’s another reason why regular diabetic eye exams are so important. Catching the problem early in its development can save most or all of your sight.

What is a diabetic eye exam?

When you come in for a diabetic eye exam, Dr. Omphroy evaluates both your visual acuity — how well you can see — and your eye health, just as with a standard comprehensive exam. But he focuses on the areas that diabetes typically damages. 

Included in the exam is a microscopic examination of the retina with a Haag-Streit slit lamp, retinal and optic nerve evaluations using a Maestro optical coherence tomography machine, and other tests that examine the health of the nerves, blood vessels, and other structures inside your eyes. 

The detailed test results allow Dr. Omphroy to diagnose and treat problems long before you develop noticeable symptoms. The early intervention allows you to adjust your diabetes regimen, as necessary, to promote better eye health.

If you have diabetes and haven’t had a diabetic eye exam, it’s time to come into Omphroy Eye Care for an evaluation as soon as possible. Give us a call at 808-487-7700 to set up an appointment at our Aiea, Hawaii, office.