Diabetes and your retina: building a follow-up plan

Start with the finding, not just the eye chart

Diabetic retinopathy affects the retina’s small blood vessels. Early changes may cause no noticeable symptoms. A person can still read well while changes are developing, so clear vision does not rule out retinal disease. ¹.

Ask whether your examination showed no retinopathy, early vessel changes, or more advanced disease. Also ask whether there is diabetic macular edema: fluid-related swelling in the macula, the part of the retina used for detailed central vision. These terms describe different findings and can lead to different follow-up plans.

Make the next examination date specific

For adults with type 2 diabetes, the first comprehensive eye examination is generally recommended at diagnosis. For type 1 diabetes, screening generally begins within five years of diagnosis. Your clinician should set the schedule for your circumstances, including age, existing eye findings and pregnancy. ².

Many people with diabetes need a dilated eye examination at least yearly; some need closer monitoring. Before leaving, ask when to return and what would make an earlier visit necessary. An annual reminder is not a substitute for the shorter interval your eye doctor recommends.

Connect the two parts of your care

Working with your diabetes team on blood glucose, blood pressure and cholesterol can help lower the risk of eye damage. Those efforts and eye examinations work together. A better blood sugar result does not establish what is happening in the retina. ³.

• Bring an updated medicine list and your recent diabetes results, if available.
• Ask for a plain-language explanation of the retinal findings.
• Ask how your eye examination report will reach the clinician managing your diabetes.
• Write down the next eye visit date and the number to call for new symptoms.

A diagnosis does not always mean an injection

Early retinopathy may be monitored while your diabetes care is managed. More advanced disease or macular swelling may require treatment. Depending on the findings, options can include medicines injected into the eye, laser treatment or surgery. The choice is individualized; ask what treatment is intended to achieve and how often reassessment is needed. ¹.

Know when the plan changes

Seek immediate eye care for sudden vision loss, a sudden shower of floaters, flashes, or a curtain or shadow over vision. Do not wait for the next routine diabetes visit or an online appointment reply. These changes need prompt assessment, even if a recent examination was reassuring. ³.

For a routine visit, plan for temporary blur and light sensitivity after dilation. Bring sunglasses and arrange a ride home. ⁴.