diabetic retinal examinations

Everyone living with diabetes, whether type 1 or type 2, is at risk of developing diabetic retinopathy and vision loss. The risk increases the longer a person has diabetes and the more advanced it is. People with type 1 diabetes are more likely to experience vision loss sooner than those with type 2 diabetes. Early detection is key to preventing vision loss so have your eyes examined yearly.

The Diabetic Eye Exam

History:

  • Any problems you’ve noticed with your vision. For example, note symptoms such as floaters (beginning, increasing numbers, etc.) or difficulty seeing at night.
  • Any recent eye injuries or eye surgeries. Include dates, doctors’ names and the names of hospitals where you were treated.
  • All current and previous significant medical conditions or operations you may have had, whether they relate to your vision or not. Don’t forget to include any diagnosed eye conditions (macular degeneration, glaucoma, cataracts, etc.), diabetes, allergies, high blood pressure or chronic health problems.
  • Your family’s current and previous history of significant medical conditions.
  • Any drugs (over-the-counter or prescription), vitamins, herbal medicines or supplements you’re taking. Note dosage and frequency.
  • Any eye drops you may be using.

Bring With You:

  • Your glasses, contact lenses, sample bottles of your current prescription and over-the-counter medications.
  • Any low vision aids or devices that you’ve been using (magnifiers, reading glasses, etc.).
  • Your health insurance card

Testing:

Visual acuity test: The standard measurement of a person’s ability to see, using an eye chart.

Tonometry: A test that measures pressure inside the eye.

Biomicroscopy: Evaluate the front structures of the eye to determine if there are any signs of diabetes

Fundus photography: This test involves taking colour photographs of both the central and peripheral retina, which allows your eye doctor to document the extent and stage of your diabetic retinopathy. These images can be compared between visits to follow the progression and/or improvement of the condition.

The Canon CR-2 Plus image is as unique as you fingerprint and provides us with a look at the health of your retina.The Canon CR-2 Plus Digital Retinal Imaging provides:

  • A high resolution image of the retina including the optic nerve, macula and the health of the blood vessels allowing for the confirmation of a healthy eye vs. detection of disease.
  • A permanent record for your file, which allows us to view your images each year to look for changes.  
  • The opportunity for you to view and discuss the image of your eye with your doctor at the time of your exam.
  • Special feature Fundus Autofluorescence (FAF) imaging: Helps with Geographic Atrophy, Macular Degeneration, Glaucoma, Diabetic Retinopathy and other conditions that can affect vision may also be identified and monitored using FAF mode.  These Metabolic changes at the level of photoreceptor/RPE complex may not be visualized by other routine imaging techniques.
    Learn more about Fundus Autofluorescence Imaging

Dilated eye exam: Drops are placed into the eye to widen the pupils to allow a direct view of the inside of your eye, including the retina. A special magnifying lens is used to examine the retina and the optic nerve for signs of damage. This test may temporarily blur your vision for a couple of hours, so you will need to bring a driver. You will need to bring sunglasses to wear as your eyes will be sensitive to the sunlight.

The dilated fundus evaluation is covered by Alberta Health Care and can be done the same day as your comprehensive eye exam. Note: this does not include a prescription for glasses.

As part of our integrated approach to health care, Dr. Farrah works closely with your family physician and allied health professionals to ensure that your eye health information is collaborated. We have close relations with local Ophthalmologists and do on-site co-management and referrals where specialist care is needed.

Reducing Risk:

Lost vision from diabetic retinopathy cannot be restored, but with early detection, treatment is often very successful and can prevent your vision from getting any worse.

The risk of developing diabetic retinopathy increases with:

High Blood Sugar (Glucose)

People with diabetes whose blood sugar is not at target are almost eight times more likely to develop diabetic retinopathy, serious vision loss and blindness. Target ranges for blood sugar can vary depending on your age, medical condition and other risk factors.

Smoking

When you have diabetes, smoking increases your risk of vision loss. It also increases blood pressure and blood sugar levels, making it harder to control diabetes.

High Blood Pressure

If you have diabetes and you also have high blood pressure and/or high lipid (fat) levels, you’re more likely to develop diabetic retinopathy.

High Cholesterol

In addition to high blood pressure, high cholesterol has also been shown to be a risk factor for developing diabetic retinopathy.

There are four ways that people living with diabetes can take to proactively reduce their risk of developing diabetic retinopathy.

1

Regular eye exams: beneficial to everyone, with or without diabetes, as your eyes are a window into your overall health. Help reduce your risk of developing diabetes-related eye conditions such as diabetic retinopathy.

If you notice the following give our office a call as soon as possible:

  • dark spots in your visual field.
  • blurred, distorted or double vision.
  • large “floaters” – specks in the form of dots, circles, lines or cobwebs that move across your field of vision. They’re most noticeable when looking at a white wall or clear sky. (These may or may not be a sign of diabetic retinopathy, but should be checked.)

If you do not have a medical condition that can affect your eyes, it is still important to get regular eye exams.

2

Maintaining blood sugar (glucose) levels: Monitoring blood sugar levels using a blood sugar monitor is important to know if you are in your target range.

3

Maintaining a proper diet and exercising regularly: three meals per day at regular times and space meals no more than four to six hours apart, and healthy snacks. Limit your sugars and , sweets such as regular pop and desserts. Limit the amount of high-fat foods you eat and consume more high fibre foods. Physical activity, including aerobic exercise and resistance training including brisk walking, running, cycling, swimming, dancing, and skiing.

4

Managing stress is an important part of blood sugar control. Physical activity can be a great way to manage stress levels and release tension.

Learn more about Diabetic Eye Disease.