Diabetic Eye Exam: Importance, Purpose, and What to Expect

Published on January 22nd, 2024

Updated on January 9th, 2025

A diabetic eye exam is an important eye test that a person with diabetes is recommended to have every 1 to 2 years, to keep track of any eye conditions that may arise as a result of this health condition. Diabetes is a chronic disease in which the body has an issue with insulin, which controls the levels of blood sugar, or glucose, in the body. Diabetes can cause several health complications, including issues within the eye. A person with diabetes may be at risk for developing conditions such as diabetic retinopathy, diabetic macula edema, cataracts, glaucoma or ocular surface issues. A person with diabetes must have an eye test, so an optometrist can keep on top of eye health. An eye test for diabetes patients may involve procedures such as retinal imaging, a dilated eye exam, optical coherence tomography (OCT) and a visual acuity test. Keep reading to learn more about a diabetic eye test and why they are an important process to undertake to look after eye health.

What is a Diabetic Eye Exam?

A diabetic eye exam refers to eye exams that are conducted to diagnose or assess any eye issues that may arise as a result of diabetes. Diabetes is a health condition in which there are high blood sugar levels, or glucose, in the body, typically due to an issue with insulin. Insulin is a hormone that controls a person’s blood sugar. If a person has diabetes, the pancreas does not make enough insulin, or the body can not use the insulin that is produced, leading to elevated blood sugar levels, according to Health Direct. Diabetes can lead to health complications such as stroke, heart attack, issues with the feet and kidney disease. Diabetes can also cause issues in the eyes, including diabetic retinopathy, macular oedema, cataracts, glaucoma and corneal issues.

A diagram of a normal eye next to a diagram of an eye affected by diabetes to highlight how diabetes can cause problems in the eyes.

What is the Purpose of a Diabetic Exam?

The purpose of a diabetic eye exam is to detect any eye issues that may arise as a result of diabetes. A diabetic eye exam is a hugely important eye test to have done as diabetes can lead to diabetic retinopathy, macular edema, glaucoma, cataracts, vitreous detachment and retinal detachment. Eye conditions such as diabetic retinopathy can lead to serious complications if left untreated, so a person with diabetes needs to get a regular eye test so an optometrist can keep track of eye health.

Who Should Perform a Diabetic Eye Exam?

An optometrist will perform an eye exam for a person who has diabetes. An optometrist will conduct a thorough eye exam to assess the eye's health and detect any potential eye conditions. A diabetic eye exam may involve an optometrist taking an image of the retina, the layer of light-sensitive cells at the back of the eye, to see if there has been any damage due to diabetes. The optometrist may use eye drops to dilate the pupil, so a clearer photo can be taken of the retina.

How Often Should Someone with Diabetes Undergo an Eye Exam?

A person with diabetes should get a regular eye test every 1 to 2 years from diagnosis, depending on advice from an optometrist. According to the American Diabetes Association, a regular diabetes eye exam is important to have, even if there are no symptoms or eye issues, as a person could be experiencing the early stages of a diabetes-related eye issue.

What is the Procedure for a Diabetic Eye Exam?

The procedure for a diabetic eye exam involves several steps. An optometrist will start a diabetic eye exam by getting a medical overview and understanding how the diabetes is progressing. The optometrist will then start the testing process which can include retinal imaging, a dilated eye exam, Optical coherence tomography (OCT) and a visual acuity test. The procedure for a diabetic eye exam is listed below.

Medical overview: An optometrist will typically start a diabetic eye exam by getting a patient's medical overview regarding diabetes, understanding how the condition is faring and assessing how it may be affecting the eyes.
Retinal imaging: Retinal imaging may be used by an optometrist to assess whether diabetes is affecting the structures at the back of the eye. Retinal imaging refers to the process of getting an image taken of the back of the eye and its structures such as the retina and optic disc. Retinal imaging is non-invasive.
Dilated eye exam: A dilated eye exam may be performed by an optometrist during an eye exam if they need a more in-depth look at the structures of the eye and how it has been affected by diabetes. A dilated eye exam involves using eye drops to dilate or enlarge the pupil so an optometrist can see the deeper structures of the eye.
Optical coherence tomography (OCT): An optical coherence tomography (OCT) may be used by an optometrist during a diabetes eye exam to assess the retina and the surrounding blood vessels. An optical coherence tomography (OCT) is an imaging test that uses light waves to take images of the retina, according to the American Academy of Ophthalmology.
Visual acuity test: An optometrist may conduct a visual acuity test to assess vision and determine whether a person needs a prescription update to their glasses.

How Long Does a Diabetic Eye Exam Usually Take?

A diabetic eye exam will usually take around 30 minutes to complete, however, the exact time will depend on the optometrist, the patient's eye care needs and the tests completed. If a person has a dilated eye exam, blurry vision from the eye drops may last up to 6 hours. It is important to check with your optometrist whether a dilated eye exam will be conducted as you may need to consider blurred vision when planning to travel home.

Are There Any Specific Preparations Required Before the Diabetic Eye Exam?

Before getting a diabetic eye exam, patients should consider making a few preparations to ensure that their test runs smoothly. Patients should bring their glasses or contact lenses to their eye exam so an optometrist can assess if these still work for them, or if a prescription update is needed. It is also important that patients who require dilated eye exams organise for transportation to and from the test, as dilating eye drops can make vision blurry for several hours after.

How Can a Diabetic Eye Exam Help in the Early Detection of Eye-Related Complications?

A diabetic eye exam allows an optometrist to examine the structures of the eyes in-depth and determine whether any eye conditions are being caused by diabetes. Though a person with diabetes may not be experiencing any symptoms or eye issues, there is the possibility that there is a diabetes-related issue developing, as most don’t show symptoms until they are severe, according to the American Diabetes Association. Eye tests allow an optometrist to detect issues early and prevent any complications.

What are Some Potential Eye Issues That These Diabetic Eye Examinations Can Detect?

There is a range of potential eye issues that an eye test for those with diabetes can detect, including diabetic retinopathy, diabetic macular oedema, cataracts, glaucoma, vitreous haemorrhage, corneal issues and ocular surface disease. The potential eye issues that diabetic eye examinations may detect are listed below.

Diabetic Retinopathy: Diabetic retinopathy is an eye issue and complication of diabetes that may be diagnosed during an eye exam.
Diabetic Macular Edema (DME): Diabetic macular edema is an eye issue resulting from complications of diabetic retinopathy and may be detected during an eye exam.
Cataracts: Cataracts is an age-related eye condition that can be diagnosed in a diabetic eye exam.
Glaucoma: Glaucoma is an eye condition that can be caused by diabetes and can be detected during an eye test.
Vitreous Hemorrhage: Vitreous haemorrhage is an eye condition that occurs when there is blood in the vitreous cavity and may be diagnosed in a diabetic eye exam.
Corneal Issues: Corneal issues or corneal diseases, refer to any eye conditions that affect the cornea and may be diagnosed through a diabetic eye exam.
Ocular Surface Problems: Ocular surface problems refer to issues with the surface of the eyes, such as dry eye, that may be caused by diabetes and can be diagnosed during an eye exam.

1. Diabetic Retinopathy

Diabetic retinopathy is an eye issue and complication of diabetes that may be diagnosed during an eye exam. Diabetic retinopathy refers to a condition in which the blood vessels in the retina are damaged due to diabetes, according to the Victorian Government’s Better Health Channel. The retina is the light-sensitive layer at the back of the eye that takes light and turns it into images. Diabetic retinopathy may not have any symptoms in its early stages, which is why those with diabetes need to get a regular eye test as an optometrist may be able to detect the issue early on. Diabetic retinopathy may be treated with laser treatment or surgery in severe cases.

2. Diabetic Macular Edema (DME)

Diabetic macular edema is an eye issue resulting from complications of diabetic retinopathy and may be detected during an eye exam. Diabetic macular edema refers to a build-up of fluid in the space between the retina and the macular, according to the American Academy of Ophthalmology, that can cause retinal thickening. Diabetic macular edema is often caused by complications of diabetic retinopathy and can affect sight if not treated. Treatment for diabetic macular edema includes intravitreal injections and laser surgery.

3. Cataracts

Cataracts is an age-related eye condition that is characterised as a clumping of protein on the eye’s lens leading to the lens becoming cloudy and can be diagnosed in a diabetic eye exam. Symptoms of cataracts include blurry vision, sensitivity to light, perceiving halos around light sources and having trouble seeing at night. The main cause of cataracts is age, as the lens naturally breaks down causing protein to clump together. Other causes include diabetes, an eye injury and certain medications. Within a diabetic eye exam, cataracts can be diagnosed through a visual acuity test, a slit-lamp exam and a retinal exam. These tests are used to identify if a cataract has formed on the eye’s lens and see if the patient’s vision is affected by the cataract. The most common treatment for cataracts is cataract surgery.

4. Glaucoma

Glaucoma is an eye condition that can be caused by diabetes and can be detected during an eye test. Glaucoma refers to a group of eye diseases that cause damage to the optic nerve, which transmits visual information to the brain. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes doubles the chances of developing glaucoma. According to the Bright Focus Foundation, type 2 diabetes in particular is a risk factor for open-angle glaucoma. Neovascular glaucoma is another type of glaucoma that can be caused by diabetes. Glaucoma can cause vision loss, so those with diabetes must get a regular eye test so the condition can be detected and treated early. Glaucoma treatment can include eye drops and surgery.

5. Vitreous Hemorrhage

Vitreous hemorrhage is an eye condition that occurs when there is blood in the vitreous cavity and may be diagnosed in a diabetic eye exam. According to an article published in the National Library of Medicine, vitreous hemorrhage may cause symptoms such as floaters and haziness in a person’s vision due to blood in the visual axis. A vitreous hemorrhage may be diagnosed through a fundoscopic exam or ultrasonography. The three most common causes of vitreous hemorrhage as reported by the American Academy of Ophthalmology, are ocular trauma, posterior vitreous detachment and proliferative diabetic retinopathy.

6. Corneal Issues

Corneal issues refer to any eye conditions that affect the cornea and may be diagnosed through a diabetic eye exam. Corneal issues or conditions include corneal abrasions, keratitis, corneal dystrophy and pterygium. The causes of corneal diseases or issues can include eye infections, eye injuries, genetic changes or genetic mutations. Common symptoms of corneal issues include eye pain, light sensitivity, blurry vision and red eyes. A corneal abrasion, which is a scratch or tear on a person’s cornea, can be diagnosed using fluorescein dye which is a type of test that may be used in a diabetic eye exam. Treatments for corneal diseases or issues include corneal transplant surgery, artificial cornea, prescription eyeglasses, contact lenses and eye drops.

7. Ocular Surface Problems

Ocular surface problems such as dry eye disease can occur due to diabetes and may be detected during an eye exam. Abnormalities in the tear film, which covers the outside of the eye and provides lubrication and protection, may lead to problems such as dry eyes. According to the study Tear film and ocular surface dysfunction in diabetes mellitus in an Indian population, published in the Indian Journal of Ophthalmology, people with diabetes may have tear film and conjunctival surface changes, including decreased tear secretion.

A list of potential eye issues that diabetic eye examinations can detect, including diabetic retinopathy, diabetic macular edema and cataracts.

How Can Early Detection of Eye Issues Through These Exams Prevent Vision Loss?

Early detection of eye issues through these exams may be able to prevent vision loss as this can mean starting your prescribed treatment plan early to prevent further damage. Early detection of eye issues may also help with producing better outcomes for conditions that require surgical treatment.

Are There Any People Who Should Not Have a Diabetic Eye Examination?

Yes, people who do not have diabetes should not have a diabetic eye exam. However, most standard eye tests typically involve examination of the retina even if they do not have diabetes, either by taking a digital scan of the retina or through a fundoscopy.

What is the Average Price of a Diabetic Eye Exam?

The average price of a diabetic eye exam can vary depending on where you get your eyes examined, your age and your overall health condition. You can contact your optometrist or local doctor for more information.

Is There Any Risk or Discomfort in Having a Diabetic Eye Exam?

There is limited risk and minimal discomfort associated with diabetic eye exams. Like standard eye tests, diabetic eye exams are generally safe and are essential for maintaining optimal eye health. Patients who require a diabetic eye exam can expect a similar process to standard eye tests, however, the optometrist may need to look more specifically at the health of your retina and the blood vessels. Pupil dilation is common in all eye tests and may cause temporary blurred vision and light sensitivity. However, these effects shouldn’t last more than a few hours. If symptoms persist, it is important to seek medical attention. It is recommended to have assistance with transport to your appointment and to wear your sunglasses when outdoors if you are getting a dilated eye test.

A person getting eye drops applied to the eye as part of a diabetic eye exam.

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