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Because significant retinopathy may be present at the time of diagnosis in people with type 2 diabetes, an eye examination by an ophthalmologist is advised at that time and annually thereafter.
Researchers estimate that more than 40% of middle-aged and older Americans with diabetes have the potentially vision-threatening eye complication retinopathy—damage to small blood vessels in the eye due to high blood glucose levels.
A review of eight diabetic retinopathy studies, a federal health survey, and Census data suggests that retinopathy affects just over four million of the roughly 10 million U.S. adults age 40 and up who have diabetes. Moreover, one in every 12 people with diabetes in this age group may have advanced, vision-threatening retinopathy.
Early treatment of even advanced retinopathy can usually halt vision loss. But diabetic retinopathy often causes no symptoms—so periodic eye exams are necessary to detect retinopathy. Even proliferative retinopathy (the most dangerous form of the disease) does not produce symptoms initially. Symptoms of proliferative retinopathy develop only when there is bleeding—the patient sees spots or showers of small spots called floaters, which can be severe enough to block vision entirely. Sudden bleeding into the vitreous humor can also cause rapid vision loss. Blurring of vision can occur if blood vessel changes cause closure of the small vessels supplying the macula (a small sensitive area at the center of the retina) or macular edema (swelling of the macula caused by leakage and accumulation of fluid).
People with type 1 diabetes should begin seeing an ophthalmologist for annual eye exams no later than five years after diabetes is diagnosed. Because significant retinopathy may be present at the time of diagnosis in people with type 2 diabetes, an eye examination by an ophthalmologist is advised at that time and annually thereafter. More frequent exams are needed for people with more advanced retinopathy.
