Understanding the Importance of Diabetic Eye Exams

Diabetes patients are at risk of developing diabetic retinopathy – an eye disorder that can lead to blindness and vision loss. As a common complication of diabetes mellitus, diabetic retinopathy is the primary cause of blindness in adults between the ages of 20 and 74. It is caused by high blood sugar damaging the blood vessels in the retina, the region of the eye that is sensitive to light. The resulting scarring can result in irreversible loss of vision.

Diabetic retinopathy is predicted to develop in 40% of diabetics over the age of 40. The risk of diabetic eye disease increases with the length of diabetes. Often, vision cannot be recovered once it has been lost.

People with diabetes should have a comprehensive eye exam at least once a year to help protect their sight.

National Eye Instuitute

According to Research to Prevent Blindness, visual loss caused by diabetic retinopathy can be avoided with early detection and treatment. One can minimize their risk of developing serious vision loss from diabetic eye disease by ninety-five percent with early detection, prompt treatment, and adequate follow up care.

Maintaining an active lifestyle, eating well, and using medication to control diabetes can also help avoid or postpone vision loss. However, in order to safeguard and maintain their eyesight and eye health, it is also important for patients with diabetes to schedule an annual eye test.

Risk Factors for Diabetic Retinopathy

Diabetic retinopathy can affect anyone with type 1, type 2, or gestational diabetes (diabetes during pregnancy). The following elements may also raise the risk:

  • Blood sugar, blood pressure, and cholesterol levels that are too high.
  • Smoking.
  • Race/ethnicity: African Americans, Hispanics/Latinos, and American Indians/Alaska Natives are at higher risk.

If a patient has diabetes, diabetic retinopathy is not the only risk to their vision. The patient also has an increased chance of macular degeneration, which impairs central vision, and cataracts, which cloud the lens of the eye. 

Patients may not notice symptoms in the early stage. That’s why it’s very important to encourage patients to get a comprehensive eye exam at least once a year to catch any problems early when treatment is most effective.

Centers for Disease Control and Prevention

Stages of Diabetic Retinopathy

There are two main stages of diabetic retinopathy:

  1. Early stage (nonproliferative): The retina’s blood vessel walls deteriorate and enlarge, creating microscopic pouches. Although patients won’t be able to see them, an ophthalmologist can. The most frequent cause of blindness in patients with diabetic retinopathy is macular edema. Macular edema develops in about half of diabetic retinopathy patients.
  1. Advanced stage (proliferative): During this phase, new blood vessels start to form in the retina. Patients may notice a few dark specks floating in their field of vision when there is mild bleeding. A large amount of bleeding may completely obscure eyesight.

Recognizing Diabetic Eye Disease Symptoms

In its early stages, diabetic retinopathy typically exhibits no symptoms at all. To detect it early and take action to preserve eyesight, it is imperative to have an eye exam once a year. 

Among the typical signs of advanced diabetic retinopathy are: 

  • Blurry vision
  • Spots or dark shapes in your vision (floaters)
  • Trouble seeing colors
  • Dark or empty areas in your vision
  • Vision loss

Overcoming Barriers

Although it is advised that people with type 1 or type 2 diabetes undergo an eye exam annually, many of them don’t. Despite the high prevalence of diabetic retinopathy, only 62.3 percent of patients with diabetes in the United States receive annual screening exams. A yearly complete eye exam can be incorporated into the self-management regimen of diabetic patients.

Diabetic Eye Exam Coverage for Medicare Patients

Medicare usually does not pay for routine eye exams; however, there is an exception for diabetic retinopathy screening. Medicare Part B covers patients for one exam per year if medical necessity is established.

Medicare Part B includes annual eye exams so that you can be routinely checked for symptoms because diabetes raises the chance of acquiring secondary problems including eye diseases. 

The patient pays 20% of the Medicare-approved cost for their doctor’s services after meeting the Part B deductible. The exam must be done by an eye doctor who’s legally allowed to do the test in your state.

Medicare enrollees with diabetes are covered for yearly eye exams; nonetheless, the prevalence of exam receipts remains low. In order to stop diabetes-related irreversible vision loss, measures to increase adherence to yearly eye exams are required.


Diabetes patients frequently experience eye issues, but there are excellent therapies available. Consistent, routine testing is essential for maintaining eye health, as is managing diabetes.

A quick, painless treatment called a diabetic retinal eye exam can help people with diabetic retinopathy or identify its early symptoms. It is important for primary care providers to encourage diabetic patients to undergo a full eye examination, which includes a retinal exam, once a year.


At a glance: Diabetic Retinopathy – Diabetic Retinopathy | National Eye Institute (nih.gov)

Fast Facts About Vision Loss – Fast Facts of Common Eye Disorders | CDC

Diabetes and Vision Loss – Diabetes and Vision Loss | Diabetes | CDC

Eye Exams for People with Diabetes – Eye Exams for People With Diabetes (webmd.com)