Diabetic Retinopathy: Evaluating Your Eyes

Healthcare provider examining man's eyes with slit lamp.

Diabetic retinopathy is a condition that happens when diabetes damages blood vessels in the rear of the eye. It can lead to vision loss. To help catch it early, have a complete dilated eye exam at least once a year. During the exam, the eye healthcare provider will review your medical history, examine your eyes, and check your vision.

Women who are pregnant and have pre-existing type 1 or type 2 diabetes have an increased risk of retinopathy. Women with diabetes should have an eye exam before pregnancy or in the first trimester. They should continue to be monitored every trimester and for 1 year after delivery, depending on the severity of the retinopathy.

Your medical history

Your eye healthcare provider may ask about the following:

  • Your diabetes type, history, treatments (such as insulin), and how you monitor your blood sugar level

  • Your family’s health, including whether any relative has had diabetes or diabetic retinopathy

  • Any diseases, surgeries, or other medical procedures you’ve had

  • Any medicines, herbs, or supplements you use, including those you buy over the counter

  • Any problems with your vision you may be having, such as blurred or double vision, problems seeing at night, or flashes or floaters 

Your eye exam

Your eye healthcare provider uses an eye chart and other tools to check your vision. Then he or she examines your eyes for signs of disease. You are given eye drops to widen (dilate) your pupils. You may have one or more of the following tests:

  • Tonometry to measure fluid pressure inside the eye.

  • Slit lamp exam to allow the healthcare provider to view the structures of your eye.

  • Ultrasound to create an image of the eye using sound waves. Ultrasound may be used if blood is found in the clear gel that fills the eye (vitreous).

  • Ocular coherence tomography (OCT) to create an image of the retina using light waves. This shows if there is fluid leaking into certain parts of the eye. It can also measure the thickness of the retina.

Fluorescein angiography

This test may be done to check the health of the inside lining of the eye (retina). It also checks the tiny blood vessels (capillaries) that carry blood to the retina. During the test:

  • Photographs are taken of the retina.

  • A dye is then injected into the bloodstream through the arm or hand. The dye travels to the capillaries in the eye.

  • More photographs are taken of the retina. The dye causes the capillaries to stand out on the photographs.

You may feel brief nausea during the procedure. For a few hours after the test, your skin, eyes, and urine may appear yellow. Talk with your healthcare provider for more information about this test.