Diabetes is a health condition that can affect many parts of the body, including the eyes. Routine eye exams can help identify the early stages of eye problems and protect a person’s vision. As such, it is advisable for a person with diabetes to have an eye exam at least once a year.

Diabetes is a condition that interferes with the body’s ability to store and regulate blood sugar. As a result, blood glucose levels may fluctuate. This can lead to high blood sugar, which can damage small blood vessels in the eye. This damage can cause vision complications, such as blurriness, cataracts, macula edema, and retinopathy.

In this article, we discuss the importance of regular eye screening for people with diabetes. We also explain how to prepare for an eye exam and provide tips for keeping the eyes healthy.

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More than 30 million people in the United States have diabetes. This condition increases the risk of eye complications due to problems that are more likely to develop in people living with diabetes. Health experts may refer to these conditions as diabetic eye diseases.

Diabetic eye screening refers to a way of detecting eye problems before they noticeably affect the vision. Screening is important because many of these conditions do not present any symptoms during the early stages, when they are most treatable.

Health experts recommend that people with diabetes have a regular eye exam once a year. However, a person should also check with a doctor how often they should undergo screening.

Controlling diabetes and receiving regular eye exams can help prevent vision problems and stop conditions from getting worse. Common eye conditions that relate to diabetes include:

Diabetic retinopathy

This condition is the leading cause of new cases of blindness among adults and the most common cause of vision loss among individuals living with diabetes. High sugar levels can damage the small blood vessels in the retina, which is the light-sensitive layer at the back of the eye.

The early stage of this condition is known as nonproliferative diabetic retinopathy. At this stage, the blood vessels weaken and begin to leak. The resulting symptoms may be mild or nonexistent.

As the condition advances, it is known as proliferative diabetic retinopathy. This occurs when the retina begins growing new, fragile blood vessels that often bleed. At this stage, the symptoms are more severe and can include vision loss and retinal detachment.

Diabetic macula edema

The macula is the central part of the retina that allows people to see color and fine detail. Diabetic macula edema describes a potential complication of retinopathy, in which leaky vessels lead to an accumulation of fluid. This fluid causes the macula to swell, resulting in blurry vision.


Glaucoma is a condition in which fluid pressure rises in the eye, potentially damaging the optic nerve and leading to vision loss. Diabetes can damage the blood vessels in the eye, which can increase the pressure. As a result, people with diabetes may be more likely than other people to develop glaucoma.


A cataract refers to a cloudy area in the lens of the eye. Cataracts commonly occur in older adults when proteins in the eye begin to break down. However, people with diabetes who experience high blood sugar, blood vessel damage, and swelling are at a higher risk of getting cataracts, which are also more likely to present at a younger age.

An eye exam is a quick, simple, and painless way for an eye doctor to check a person’s eye health. The test allows them to check for eye problems early on, when they are easier to treat and before they cause vision complications.

A routine eye test for a person with diabetes will typically involve a dilated eye exam. A doctor will give a person eye drops to dilate, or widen, their pupils. Dilating the eye provides an optometrist or ophthalmologist with a better view of the structures inside the eye to help them detect potential problems.

During the test, in addition to checking inside the eye, the eye specialist will check a person’s vision, eye muscles, eye pressure, and response to light.

Depending on the results of the exam, the optometrist or ophthalmologist will advise a person on when they should next test their eyes. They will usually suggest that people with diabetes test their eyes yearly if they are otherwise in good health.

However, a diabetes healthcare team may suggest a different plan depending on the type of diabetes and time since diagnosis.

A person does not need to prepare anything before undergoing a dilated eye exam. However, it is advisable for them to manage their blood sugar and attempt to maintain glycemic control throughout the exam.

It usually takes 20–30 minutes for a person’s pupils to dilate fully. However, the duration of dilation may last between 4 and 24 hours. As such, a person may experience blurry vision and light sensitivity for a few hours after the exam. Therefore, it is not advisable for a person to drive after this exam, and they should arrange for a friend or family member to escort them home after the appointment.

For individuals who are unable to afford eye exams or lack vision insurance, the following resources may be helpful:

Diabetic eye diseases are a group of conditions that can result from diabetes. These conditions typically occur due to high blood sugar levels gradually damaging blood vessels in the eyes.

While anyone with diabetes can develop these conditions, they are more likely to occur in individuals with untreated high blood glucose and high blood pressure. Other factors that may also increase the risk include:

  • high blood cholesterol
  • smoking
  • older age
  • duration of time a person has had diabetes
  • pregnancy

People belonging to certain racial and ethnic groups are also at higher risk. These groups include:

  • African Americans
  • American Indians
  • Alaska Natives
  • Hispanic people
  • Latinx individuals
  • Pacific Islanders

Often, a person with diabetes may not notice any symptoms of diabetic eye disease. This is why screening is vital to catch early signs of any problems. When a person does experience symptoms, these may include:

  • blurry vision
  • changes in vision
  • vision loss
  • poor color vision
  • seeing floaters
  • flashes of lights

Anyone who notices any of these symptoms should consult an eye doctor.

An eye doctor will be able to check and diagnose any eye problems during a routine dilated eye exam. In some cases, they may take a picture of the eye, known as a retinal photograph, to help them detect and measure any changes to the eye at each exam. Alternatively, they may use ocular coherence tomography to check for retinal thickening.

Other tests may also be necessary depending on a person’s health history.

After diagnosing an eye condition, an eye doctor may recommend more regular eye exams and suggest changes to a person’s diabetes management plan. In some cases, ophthalmologists may treat these conditions with medication, laser treatments, surgery, or a combination of these treatments.

Anti-VEGF medicines are one treatment option. These drugs block the activity of a protein known as vascular endothelial growth factor, which creates new blood vessels that can leak. Blocking this protein can help slow the growth of new blood vessels and stop fluid leaks. A doctor will use anesthesia before injecting anti-VEGF medication into the eyes.

Laser treatments use intense beams of light to shrink or destroy any abnormal or leaking blood vessels that are causing vision problems.

Surgical options may include vitrectomy or cataract surgery. The former removes the clear gel present in the center of the eye, called the vitreous gel. This can help treat problems with severe bleeding or scar tissue. The latter involves surgery to remove the cloudy cataract lens and replace it with an artificial lens.

To help prevent eye complications, it is important for a person to receive a comprehensive eye exam with dilation every year. This thorough exam of the eye can help catch conditions early, before complications arise.

Additional tips to help maintain eye health include:

  • Maintaining blood sugar levels: By controlling and managing their A1C, blood pressure, and cholesterol levels, a person can help prevent vision complications.
  • Knowing family history: As many eye conditions are hereditary, this information can help determine whether a person is at higher risk.
  • Maintaining a moderate weight: In addition to managing blood sugar levels, a nutritious, well-balanced diet and regular exercise can benefit eye health.
  • Wearing protective eyewear and practicing eye safety: Using safety glasses, sunglasses, goggles, safety shields, and eye guards can help protect the eyes when playing sports, working with machinery, or doing other activities.
  • Quitting smoking: Smoking can negatively affect health, including the vision.
  • Giving the eyes a rest: If a person spends a lot of time on a computer, phone, or tablet, regular screen breaks are important to reduce eyestrain.
  • Cleaning the hands and contact lenses: If a person wears contact lenses, they should thoroughly wash their hands when handling the lenses and disinfect the lenses to prevent infections.

Diabetes is a health condition that can affect the eyes. Many diabetic eye conditions typically present without any noticeable symptoms.

As such, it is vital that people with diabetes attend yearly eye exams. An eye doctor can check their eye health and identify any conditions in the early stages, when they are easier to treat and before they can cause permanent damage.