Eye Test for Diabetic Retinopathy


The diagnosis of diabetic retinopathy is made solely by an examination of the back of the eye and the retina. It is advised that if you are suffering form diabetes, you undergo regular eye tests by an eye care professional on an annual basis. Because there are no direct symptoms, it is in these checks that most cases of retinopathy are diagnosed. An early diagnostic could potentially save your eyesight. Being diagnosed early will also contribute to more successful treatment.

Everyone who has diabetes should undergo eye tests. You can have this check carried out by your optometrist at your opticians, or even your local general practitioner who treats you for diabetes.  If any detection of the condition is picked up, you will likely be referred to an eye clinic, where a more trained doctor in this area will be better placed to diagnose you further. The amount of treatment needed is subject to how far the retinopathy has progressed.

Diabetic retinopathy is tested for, using a dilated eye examination. The eye care professional will be looking for early warning signs to make a proper diagnostic. First of all, they will be looking to identify any leaking within the blood vessels. The leaking is one of the first signs and can happen in background retinopathy or maculopathy. The second thing they will be looking for and again, something which happens in the initial stages is the swelling of the retina. This is accompanied by a check to ensure there is no blood or fatty deposits contaminating the retina. The vitreous, or jelly like substance which fills our eye is also checked for bleeding.

Any abnormal swelling or problems with the blood vessels are checked and can be directly attributed to growths, which occur on the retina. These must be treated, as if left to grow they can cause scarring on the retina and damage our peripheral vision. Damage to the nerve tissue and whether or not the retina has detached it self altogether is addressed, which can culminate as a result of the complications and abnormalities.

The examination will consist of three stages. The first will be a visual acuity test to determine your visual ability to see how your sight copes at various distances. This is usually done simply through eye charts. The second is a dilated eye exam, in which drops will be applied to your eyes to make them wider and to dilate the pupils, in order for your retina to be examined properly. They will use lenses as magnifying devices, so as to examine the retina and optical nerve for any signs of damage and complications. Take care and prepare in advance however, as this will cause a blurring of vision for several hours afterwards. The third and final test is a tonometry, in which the eye is numbed and specially designed instruments will test the pressure within the eye.

If your eye doctor feels that you are in need of further treatment for macular oedema, particularly due to the swelling of the retina, they will often prescribe a fluorescein angiogram. This is a test in which a dye is injected into the blood flow via the arm and observed when it reaches the blood vessels in the retina. This clarifies the vessels visibility and enables them to identify the root or the origins of the leaks within the blood vessels. Patients should be advised however, that although the treatment causes no real discomfort, there are a few side effects. For example, the dye will cause slight skin discolouration, giving it a yellow tone and urine may appear orange for a while afterwards. Nevertheless, most patients don’t have any problems with this, as the benefits far outweigh the negatives. Some patients may feel nauseous afterwards and, as with all angiogram tests, some may be allergic. Because of this, the test is usually only used on those who are already suspected to have retinopathy by their doctors.

Your doctor might also suggest you take an optical coherence tomography exam, or OCT for short. This is essentially a test, which provides the doctor with images of a cross section of the retina. From this they are able to judge the thickness of the retina, to be able to diagnose swellings or to see if the retinal tissue has been affected by leaking fluid. This swelling can be the cause of the vision loss and help the doctor identify any areas whereby the vitreous gel has attached itself to the retina, which can cause further problems. This may be continued later on to test the effectiveness of the treatment or to evaluate the severity of the leaking.

During your check up, your doctor will be assessing your condition to judge whether or not you have retinopathy and if so, at what stage. Most people who have checks regularly and are diagnosed early have either background or non proliferative retinopathy. Non proliferative is usually diagnosed and is the cause of around 80% of cases of retinopathy. The more frequent the checks, the more likely you are to be diagnosed in an early stage where the doctor will be able to prevent and treat the condition better. Those who leave the condition to aggravate without diagnosis are far more likely to suffer from visual impairment in the future.

It is also crucial to note that pregnant women with diabetes are more exposed to diabetic retinopathy and should at some point undergo a dilated eye examination. It would also be advised, and may well be recommended by your doctor, that you attend several examinations throughout your pregnancy. However, women who have contracted diabetes directly through pregnancy are not at risk. Retinopathy generally affects those who have had diabetes for a long time and had prolonged exposure to the high blood sugar levels. Those relatively new to it are still at risk, but less so and are better placed in finding an early diagnostic and keeping on top of retinopathy prevention.



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