It is important to recognize that people with diabetic retinopathy may not necessarily have visual changes even in more advanced stages.
- Gradual, progressive blurring of vision
- Sudden, severe vision loss
- Fluctuating vision
It is important and mandatory that people with diabetes mellitus have their eyes examined at least annually.
A complete ophthalmic examination is important in the assessment of diabetic retinopathy and this includes vision testing, drops to dilate pupils, and a complete examination of the front and back of the eye.
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People who maintain healthy, active lifestyles and who optimize their blood sugar control have the best chance of slowing progression of diabetic retinopathy and preserving good vision.
It is very important that people with diabetes mellitus undergo at least an annual eye exam, whether or not they have any vision symptoms. It is important to remember that diabetic retinopathy may progress and not cause any symptoms. It is also very important for people to understand that their blood glucose (sugar) control should be as good as possible with the goal of keeping the hemoglobin A1C level at a target level set by the physician guiding the treatment of the blood sugars.
People with diabetic retinopathy may undergo several types of tests in order to evaluate their condition.
People may undergo digital photography of their retina to document the stage and findings of diabetic retinopathy. There are no risks associated with this simple test.
Fluorescein angiography may be used to determine the extent of diabetic retinopathy or to detect areas of leakage or bleeding that may lead to vision loss. The test is performed by injecting sodium fluorescein dye into a peripheral vein with a small needle. This dye then goes through the body and retina to show blood flow and various features of retinopathy such as leakage. It is considered a routine and safe test, but people should expect some temporary, mild yellowish tinting of skin and orange colored urine. Most people have no difficulty with this test, although a low percentage of people will experience some transient, mild nausea after the injection. Very rarely, allergic or even more severe reactions can occur.
Optical Coherence Tomography (OCT)
OCT imaging is a fast, non-invasive test that uses a low energy laser to scan the macula and determine whether there is swelling or distortion of the macula in the setting of diabetic retinopathy. The test is also useful to assess the response to diabetic macular edema treatment.
B Scan Ultrasonography
This test utilizes standard, non-invasive ultrasound technology and is used in the office to view the retina when the retina cannot be directly visualized by the doctor with standard examination techniques, such as in the setting of a severe vitreous hemorrhage. Typically the doctor will recommend the test to rule out retinal tears and any pulling on or detachment of the retina. Certain types of retinal detachment may need relatively urgent surgery.