Early signs of diabetic retinopathy and how often you need eye check-ups (tests)
Patient's Query
Hey, I have diabetes and I keep hearing about “diabetic retinopathy.” But my vision feels normal, and I also have a cataract that I was told needs surgery later.
So I am confused. If my eyesight is fine, does that mean my retina is also fine? I drive at night sometimes, and lately I feel glare from headlights, and I misjudge how near a vehicle is. I thought it was just bad road lighting.
Could that be a retina issue? What are the early warning signs of diabetic eye disease, and how often should I do an eye check? Please tell me clearly which test I need, and how frequently, so I do not miss it.
Endocrinologist Answers
Diabetic retinopathy is tricky because early stages often have no symptoms. Many people say, “My vision is normal”, and still have early retinal changes. That is why screening is important.[1]
A cataract can blur vision, but it is not the same as retinopathy. Retinopathy affects the retina’s blood vessels and can quietly progress.
Early signs patients may notice include:
- Blurring that comes and goes.
- Difficulty with night driving, glare, and slow recovery after bright lights.
- Trouble judging depth, stairs, curbs, or distance of vehicles.
- New floaters, black spots, or a curtain-like shadow.
- Straight lines looking bent, which can suggest macular involvement.
If you ever get sudden floaters, a shadow, or sudden vision loss, treat it as urgent.
How often should you do eye exams?
- Type 2 diabetes: a dilated retinal exam at diagnosis, because retinopathy can already be present.[1,3]
- Type 1 diabetes: first dilated exam within 5 years of diagnosis.[2,3]
- If the retina is normal, many guidelines allow follow-up every 1 to 2 years. If any retinopathy is present, it is usually at least yearly, sometimes more often depending on severity.[1,4]
The best protection is steady sugar control, blood pressure control, and regular screening.
References:
- https://diabetesjournals.org/care/article/49/Supplement_1/S261/163919/12-Retinopathy-Neuropathy-and-Foot-Care-Standards/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5402875/
- https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-vision-loss.html
- https://www.aao.org/education/preferred-practice-pattern/diabetic-retinopathy-ppp/
Disclaimer: The information provided in this Q&A is for educational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional for personalized medical guidance and treatment recommendations.