What Happens During a Diabetic Eye Exam?

Can a simple eye check-up reveal the unseen impact of diabetes on your eyes? Despite what many assume, diabetic eye exams involve more than just checking your vision; they are comprehensive evaluations that can detect hidden damage of the disease.

I’m Minh Van Tran, the owner and principal optometrist at VisionPro. Our practice has a special focus on serving the diverse communities of Footscray and St. Albans. I’m passionate about delivering top-notch eye care and helping our patients maintain their vision and general well-being. So I’d like to share some professional insights about what happens during diabetic eye exams at our optometry practice.

Early detection is your best defense against diabetic eye diseases. So secure your vision for the future by booking an eye care consultation with us now.

Key Stages of Diabetic Retinopathy

What do the key stages of diabetic retinopathy entail, and why should we pay attention to them? Let’s delve into these stages and understand their significance in preserving your vision:

• Mild Non-Proliferative Retinopathy: In this early stage, small areas of swelling may develop in the retina’s blood vessels. These micro-aneurysms can leak fluid into the retina, causing it to swell. While symptoms may be subtle at this stage, it’s crucial to address these warning signs promptly to prevent progression.
• Severe Non-Proliferative Retinopathy: As the condition advances, more severe signs may emerge. These include a significant increase in the number of damaged blood vessels, as well as the development of blocked or closed blood vessels. These changes can lead to a reduction in blood flow to the retina, increasing the risk of vision loss if left untreated.
• Proliferative Retinopathy: In the most advanced stage of diabetic retinopathy, new blood vessels begin to grow on the surface of the retina. These abnormal vessels are fragile and prone to leaking blood into the vitreous, the gel-like substance that fills the eye. This can result in severe vision impairment and even blindness if not managed effectively.

Understanding these stages is crucial for early detection and intervention. By identifying diabetic retinopathy in its early stages, we can implement timely treatments to prevent further progression and preserve your vision for the long term.

 

 

What is DME?

Diabetic macular edema (DME) is a serious complication of diabetic retinopathy, specifically targeting the macula, which is the central part of the retina crucial for sharp, straight-ahead vision and color perception.

DME occurs when blood vessels in the retina are damaged by the chronic high blood sugar levels associated with diabetes, leading them to leak fluid and lipids. This leakage causes the macula to swell (edema), distorting vision and impairing the ability to see fine details, which is essential for activities like reading and driving.

If left untreated, the continuous swelling can lead to permanent vision loss.

 

Diabetic Eye Exams at VisionPro

When you entrust your diabetic eye care to VisionPro you’re embarking on a journey towards preserving your precious vision and overall well-being. Our comprehensive diabetic eye exams may study your eye condition from a number of different perspectives.

Here are some of the eye tests we may conduct during your visit:

• Initial Consultation and Patient History: The initial consultation is important for effective diabetic eye care. We gather comprehensive details about your health, diabetes management, medication, and lifestyle factors. This information helps identify risks associated with diabetic retinopathy, such as blood sugar levels and hypertension, which are integral to tailoring your eye care. Understanding these factors allows us to anticipate potential complications and adjust treatment plans proactively.
• Pupil Dilation: By administering eye drops to widen the pupils, optometrists gain an unobstructed view of the retina, allowing for a thorough examination. This process reveals critical details of the retina, optic nerve, and blood vessels, enabling the detection of diabetic retinopathy signs such as micro-aneurysms, hemorrhages, and neo-vascularization. The insights gained from a dilated eye exam are vital for assessing the disease’s presence and severity, guiding timely intervention strategies to prevent further deterioration of vision.
• Retinal Photography: These photographs serve as a baseline for monitoring the progression of retinal disease over time. Regular retinal photography allows for precise comparisons with previous images, making it easier to detect subtle changes or developments in the condition. This ongoing record is essential for assessing the effectiveness of current management strategies and making timely adjustments to treatment.
• Visual Field Testing: Visual field testing involves having the patient look straight ahead into a machine and respond to light stimuli that appear in different areas of their peripheral vision. This test helps detect any blind spots or peripheral vision loss, which can be indicators of advanced stages of diabetic retinopathy or other ocular conditions affecting the retina or optic nerve.
• Visual Acuity Testing: We employ a series of tests that measure your ability to see details at various distances, contrasting levels, and under different lighting conditions, which provides a nuanced understanding of your visual capabilities. This thorough examination helps us detect subtle shifts in vision that might not be evident in everyday activities but indicate the onset of eye health issues, such as early stages of diabetic retinopathy, cataracts, or changes in the optical power of the eye.
• Ultra-Wide Imaging: This advanced photographic technique captures up to 200 degrees of the retina in one image, far surpassing the 30 to 45 degrees covered by traditional methods. Ultra-Wide Imaging is critical for a comprehensive assessment of the peripheral retina, where signs of diabetic retinopathy often first appear but may go undetected with standard imaging.
• Fundus Fluorescein Angiography (FFA): This diagnostic procedure involves injecting a special dye into the bloodstream, which highlights the blood vessels in the back of the eye. It is used to detect and evaluate leaking blood vessels, capillary non-perfusion (areas of the retina without blood flow), and new blood vessel growth, which are indicative of proliferative diabetic retinopathy.
• OCT Macular: Optical Coherence Tomography (OCT) of the macula provides high-resolution cross-sectional images of the retina. It helps in identifying any swelling or fluid accumulation (macular edema), which is a common complication of diabetic retinopathy. OCT is invaluable in determining the severity of edema and monitoring the response to treatment.
• Slit-lamp Biomicroscopy: During this examination, a special microscope with a bright light, called a slit-lamp, is used to examine the front and back parts of the eye in detail. It is effective for assessing the overall eye health and detecting signs of diabetic retinopathy such as micro-aneurysms, hemorrhages, and other abnormalities in the retina.
• Gonioscopy: A special contact lens called a gonioscope is placed on the eye’s surface after numbing it with anesthetic drops. This test allows the optometrist to examine the eye’s drainage angle—the area between the iris and the cornea—to check for any signs of neo-vascularization or other abnormalities that could lead to glaucoma. It is crucial for detecting neovascular glaucoma, a potential complication of proliferative diabetic retinopathy, thereby guiding treatment decisions to prevent further damage.

In summary, our diabetic eye exams at VisionPro Optometrists are comprehensive and tailored to your needs. From initial consultation to advanced diagnostic techniques, we prioritize early detection and personalized care to preserve your vision and enhance your overall well-being.

If you would like to see an example of an optometrist conducting retinal photography, watch the following video from EMIS Care.

After the Diabetic Eye Exam: Treatment Options

What treatment options are available for diabetic retinopathy? Typically, we would refer you to a trusted ophthalmologist for advanced treatment and co-management.

Laser surgery is integral in managing diabetic retinopathy. An ophthalmologist uses targeted laser beams to seal off leaking blood vessels or shrink abnormal ones, preventing further damage to the retina and reducing the risk of vision loss.

Additionally, an ophthalmologist may use corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) drugs. Corticosteroids, available as eye drops, pills, or injections, reduce inflammation and macular edema, stabilizing vision. Anti-VEGF drugs, administered through injections, inhibit proteins that promote abnormal blood vessel growth and leakage, effectively addressing the underlying processes of proliferative diabetic retinopathy and macular edema.

In advanced stages of diabetic retinopathy, an ophthalmologist may resort to vitrectomy surgery. This procedure involves removing the vitreous gel from the eye to repair or remove damaged blood vessels or scar tissue, facilitating the recovery of healthier tissue.

The goal of treatment for diabetic retinopathy is to prevent further vision loss and preserve remaining vision by utilizing a combination of laser surgery, medications, and surgical interventions as needed, tailoring treatment to provide the best possible outcomes for eye health.

 

CONCLUSION

Our practice uses advanced diagnostic tools to accurately assess the health of your retina and detect any early signs of damage. Regular diabetic eye exams are crucial for early detection of diabetic retinopathy, a condition that can lead to significant vision loss if left unchecked.

Ignoring the need for a diabetic eye exam can silently escalate into irreversible vision loss, impacting your independence and quality of life.

Take control of your eye health before diabetes does; a consultation today can pave the way for clear vision tomorrow.

Scheduling an eye exam appointment is the first step.

Click on the “BOOK AN APPOINTMENT” button OR call either our St. Albans (03) 9364 5509 or Footscray ((03) 9687 8787  optometry practices.