What’s involved in a diabetic eye exam?

mature woman getting dilation eye drops inserted into her eye

What is a diabetic eye exam? A diabetic eye exam goes further than a comprehensive exam and includes tests to monitor the health of your optic nerve and retina and to consistently check for glaucoma. 

These tests play a critical role in maintaining eye health and identifying vision disorders early, before they can cause any damage.

Most of the optical disorders caused by diabetes don’t show symptoms until they’re more advanced, so maintaining a strict schedule of eye exams can ensure doctors start treatment before any conditions worsen.

Let’s go over what a diabetic eye exam is, what’s involved and why it’s so important.

What does a diabetic eye exam include?

While diabetic eye exams are similar to non-diabetic exams, diabetic eye exams take extra precautions to monitor the retina and blood vessels inside the eye. These additional steps are crucial to preventing blindness down the road.


For a diabetic patient, dilation is the critical component of the eye exam.

During dilation, an eye doctor administers eye drops into each eye. Around half an hour later, the pupils will appear wide open. This temporarily blurs the patient’s vision and increases light sensitivity.

A wider pupil gives doctors a more comprehensive view of the retina, blood vessels and other anatomy of the back of your eye. Without dilation, a doctor’s view is much more narrow — making any retinal issues harder or even impossible to examine.

Dilated eyes also offer a better view of the optic nerve and any damage that could occur, or has already occurred.

While your eyes are dilated, an eye doctor could opt for one or more additional tests, like a fluorescein angiography (using intravenous dye to find blood vessel leaks) or optical coherence tomography (a cross-section image of the retina).

Glaucoma test

It’s important to monitor diabetics for any changes to intraocular pressure, which is the pressure built up from the natural fluid inside the eye. High pressure can indicate the presence of glaucoma.

Early diagnosis is important for the overall prognosis and treatment of glaucoma.

Glaucoma testing usually comes in the form of the common “puff-of-air” test, but additional testing can obtain more exact measurements if needed.

Vision test

This is a common part of every eye exam. An eye doctor asks the patient to look at an eye chart in the distance and read large and small letters to test their vision clarity. The eye doctor has the patient cover each eye and read the same chart, to test for any inconsistencies between eyes.

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What do diabetic exams check for?

In addition to glaucoma, diabetic eye exams check for complications like diabetic retinopathy and diabetic macular edema.

Diabetic retinopathy, a leading cause of blindness among American adults, occurs when blood vessels inside the eye start to leak. Left untreated, the leakages worsen over time and lead to varying levels of blindness. Early detection and treatment can often save part or all of your eyesight.

Diabetic macular edema (DME) is a swelling of the macula, located in the back of the eye. It’s responsible for central vision and seeing color. When a patient with diabetic retinopathy experiences any vision loss, DME is the most common cause.

Is there an additional cost for a diabetic eye exam?

Diabetic eye exams are usually billed as medical eye examinations. For this reason, costs will likely differ from a standard comprehensive eye exam.

Any available medical insurance may be used for these exams, since vision insurance typically only covers routine, non-medical eye exams.

When do I need a diabetic eye exam?

According to the American Diabetes Association (ADA), people with diabetes should follow strict precautions to ensure ongoing eye health:

  • Adults with type 1 diabetes should schedule an eye exam within five years of their diagnosis.

  • Adults with type 2 diabetes should schedule an exam as soon after their diagnosis as possible.

  • When possible, women with diabetes who are planning to get pregnant should consult with their eye doctor beforehand. An eye exam also should be scheduled within the first three months of development. Another exam should be scheduled a year after giving birth.

After an initial exam, the ADA recommends getting annual diabetic exams to monitor the health of your eyes. It’s important to specifically schedule a diabetic eye exam; a typical comprehensive eye exam will not focus enough on the specific needs of a diabetic patient.

If your eye doctor notes any abnormalities with your eyes, he or she may recommend exams more often than once a year. Only your optometrist, ophthalmologists or retinal specialist can tailor a diabetic eye exam schedule specifically for you.

The eyes can be among the first parts of your body affected by diabetes. But maintaining a regular routine of diabetic eye exams will ensure any problems are diagnosed and treated early — making lifelong, healthy vision a reality.

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