Seeing clearly: Why eye checks matter in diabetes

A patient with diabetes came to see me at my clinic today and thought I was in my twenties. (I’m about twice that age). As much as I was flattered, I couldn’t help but wonder if something was wrong with his vision. I smiled, thanked him for the compliment, and gently told him, “You really need to get your eyes checked — by an ophthalmologist.”

It may have sounded like a light-hearted moment, but it touched on something serious: the silent way that diabetes can affect your eyesight. It’s easy to assume that our eyes are fine as long as we can read, drive, and recognize faces. But with diabetes, damage to the eyes can happen long before any noticeable symptoms appear. That’s why yearly eye exams by an ophthalmologist are not just a good idea — they are essential.

Diabetes and the eyes

Diabetes affects blood vessels throughout the body, including the delicate vessels in the back of the eye, in a part called the retina. This condition, known as diabetic retinopathy, is one of the leading causes of blindness. High blood glucose levels can weaken these vessels, eventually leading to swelling, bleeding, and scarring in the retina.

What’s especially alarming is that diabetic retinopathy often develops without pain or obvious changes in vision. By the time a person notices blurred vision or dark spots, the damage may already be advanced. Early detection is key, and that’s only possible with regular eye exams by someone trained to look inside the eye — an ophthalmologist.

Why an ophthalmologist?

Many patients ask, “Can I just go to an optical shop or see an optometrist?” While optometrists are trained in vision care and can prescribe glasses, they are not medical doctors. They are not equipped to manage the medical complications of diabetes that can silently affect your eyes.

An ophthalmologist, on the other hand, is a medical doctor who specializes in eye diseases and can detect subtle signs of diabetic retinopathy and other diabetes-related complications like macular edema, cataracts, and even glaucoma. They can perform a dilated eye exam and imaging tests to assess the health of your retina and optic nerve.

If you’ve been diagnosed with type 1 or type 2 diabetes, the recommendation is clear: See an ophthalmologist at least once a year, even if you have no symptoms. To remember, I tell my patients to get their eyes checked around the time of their birthday so they don’t forget.

Early detection saves sight

The good news is that diabetic eye disease is treatable, especially when caught early. Laser therapy, injections, and even surgery can help preserve or restore vision. But we can only treat what we know about — and we will only know about it if you get your eyes checked.

I’ve had patients regret skipping their annual eye exam after they were diagnosed with advanced retinopathy that could have been prevented or managed earlier. On the other hand, I’ve seen many who caught the problem in its early stages and avoided vision loss altogether.

Protecting more than just sight

Getting your eyes checked is about more than just your vision. It’s a window into your overall vascular health. In fact, changes in the retina may offer clues about how well your diabetes is being controlled and whether other organs might be at risk.

So, the next time someone compliments me on looking younger than my years, I’ll take it — but I might also ask about their last eye exam. If you have diabetes, consider this your reminder: book that appointment with an ophthalmologist. Your eyes, and your future, will thank you for it.