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Diabetic Eye Exams

If you are diabetic, it is very important to have annual dilated diabetic eye exams. When blood sugar is uncontrolled, over time this can lead to bleeding in the retina, also known as diabetic retinopathy. The retina is the structure in the back of your eye that absorbs light and transmits information to your brain. Damage to the retina from diabetes is one of the leading causes of blindness. The good news is that retinopathy can be reversed if detected early.

Both Type I and Type 2 diabetics are at risk for developing diabetic retinopathy. The better controlled your blood sugar is, the lower risk you have for developing both diabetic retinopathy and other diabetic complications. When diabetic retinopathy first develops, most patients don’t have any visual symptoms.

During eye exams, Dr. Langer dilates the eye and looks with a biomicroscope at the retina for any signs of retinopathy. This allows Dr. Langer to detect diabetic changes to the eye before symptoms are present. If retinopathy is caught early, there are much better treatment options that can greatly improve the chance of preventing blindness. Left untreated, with uncontrolled blood sugar diabetic retinopathy will progress to blindness.

It is very important to check your fasting blood sugar regularly and make sure your HbA1c (a three month blood sugar test taken by your endocrinologist or primary care doctor) is stable. Patients with stable blood sugar have a much lower rate of diabetic retinopathy and other systemic diabetic complications. If fasting blood sugar levels are over 200 mg/DL, temporary swelling of the ocular lens may occur. This can lead to an unreliable measurement of your glasses prescription. If you are diabetic, make sure your fasting blood sugar level is below 200 mg/DL before getting your eyes checked for glasses.

Proliferative diabetic retinopathy
A side by side comparison of a normal retina (left) versus a retina with proliferative diabetic retinopathy (right).

The eyes are fascinating because they are the one place in the body where one can see diabetic complications without performing invasive surgical procedures. If diabetic retinopathy is present in the eyes, it is likely occurring undetected in other parts of the body. For instance, peripheral neuropathy causes patients to lose feeling in their extremities and can lead to the inability to walk. Uncontrolled diabetes can also lead to kidney disease. Many patients presenting with diabetic retinopathy are at risk for developing these and other diabetic complications. By detecting retinopathy early on, we can initiate treatments that not only halt the progression of this eye disease, but reduce the risk of other diabetic complications.

Dr. Langer works closely with your primary care doctor or endocrinologist to inform them of any ocular changes which may necessitate changes to diabetic medications, nutrition planning, and exercise regimens. Dr. Langer also is able to co-manage diabetic patients with area ophthalmologists when retinopathy progresses and requires surgical intervention.