What To Expect From a Thorough Eye Examination When You Have Diabetes
Have your questions and your answers ready when visiting the eye doctor
Because all people with diabetes are at increased risk for eye complications, I believe it is imperative that each of us have a sense of what constitutes a high-quality eye examination (especially those of us who aren't eye doctors!). While it is unlikely that any two doctors will conduct an examination in exactly the same way, I'd like to describe the fundamentals of an eye exam that will allow you to ask the right questions and assess the thoroughness of your examination experience.
People with diabetes should be asked how long they have had diabetes, the specific medications they are using for diabetes treatment, the previous diagnosis of any diabetes complications (eye, kidney, nerve or vascular), the frequency and range of home blood glucose readings, the most recent home reading, and the results of their last glycosylated hemoglobin test (HbA1c). The answers to these questions will give the eye doctor a good sense of overall diabetes control and the likelihood of finding eye complications. It is your responsibility to know the answers to these very important questions.
The patient is asked to read the eye chart wearing any corrective lenses previously prescribed. The results allow the doctor to gauge just how far off the prescription might be, or the effects of any eye diseases (e.g., cataracts or diabetic retinopathy, to name just two of many possibilities) that will be uncovered in subsequent parts of the eye exam.
Eye Muscle Coordination
Diabetes can affect the nerves controlling eye muscles, so tests of muscle coordination should always be done (e.g., following a moving target with both eyes).
Testing Diabetes can subtly affect color perception, and such defects may precede the development of diabetic retinopathy.
A bright light is shined into each eye. This checks the neurological integrity of the connections between the optic nerve and the brain, and may reveal neurological disease due to diabetes or other causes.
A test of peripheral (side) vision also assesses the eye/brain connection and is very useful for detecting neurological problems, including glaucoma, which are more common with diabetes.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...