How Often Should People With Diabetes Have a Dilated Eye Exam?

Diabetes is the leading cause of new blindness in working-age adults, and it remains a major threat to vision after 55. The frustrating part is that early diabetic retinopathy feels like nothing at all. Your vision is fine right up until it is not.

Recommended Screening Intervals

• Type 2 diabetes: Dilated retinal exam at diagnosis, then at least once a year.
• Type 1 diabetes: First exam within five years of diagnosis, then annually.
• Pregnancy with pre-existing diabetes: Exam before conception or in the first trimester, with follow-up through pregnancy and one year postpartum.
• Any diabetic retinopathy already present: Every three to six months, or as directed.

If your exams have been clean for several years and your blood sugar is well controlled, your doctor may extend the interval to every two years. That decision should be made by the physician who examined your retina, not assumed.

What the Exam Includes

Drops widen your pupils so the entire retina can be examined. Dr. Garg looks for microaneurysms, hemorrhages, cotton-wool spots, hard exudates, and abnormal new vessels. OCT imaging measures whether fluid has collected in the macula — the change most likely to affect your reading vision. In some cases, fluorescein angiography or widefield imaging maps areas of poor circulation.

Expect light sensitivity and blurry near vision for four to six hours afterward. Bring sunglasses and a driver.

Stages, Briefly

1. Mild to moderate non-proliferative retinopathy — early vessel damage, usually monitored.
2. Severe non-proliferative retinopathy — widespread damage, high risk of progression.
3. Proliferative retinopathy — fragile new vessels grow, risking bleeding and traction detachment.
4. Diabetic macular edema — swelling in the central retina, which can occur at any stage.

Treatments That Work

Anti-VEGF injections, targeted laser (focal or panretinal photocoagulation), steroid implants, and — in advanced cases — vitrectomy surgery all have strong track records. Treatment works best before you notice symptoms, which is the entire argument for screening.

What You Control Between Visits

• Keep A1C at the target your physician sets
• Control blood pressure and cholesterol
• Do not smoke
• Report any new blurring, floaters, or dark spots immediately rather than waiting for your next appointment

Bring your most recent A1C to your visit so we can look at the whole picture together. To schedule, call (954) 633-8202.