Ask the Eye Doctor

Ask the Eye Doctor

VSP® Vision Care, a national strategic partner of the American Diabetes Association, is committed to the ADA's mission and raising awareness about the importance of annual eye exams, especially as it relates to diabetes. Dr. Phelps, a VSP doctor, answers your questions here about eye health and diabetes.

Please review the list of most recently asked questions below and if your area of concern is not addressed, we encourage you to submit a question to our expert – be sure to check back in two weeks to see the answer.

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Top 10 Questions & Answers

1. I have been diagnosed with diabetes. Will I go blind?
   
2. What is diabetic retinopathy?
3. What is the biggest misstep patients with diabetes make?
4. How often should I go to the eye doctor if I have diabetes?
5. As a person with diabetes, what should I be prepared to share with my eye doctor on each visit?
6. Are there differences in how my vision will be affected depending on type 1 or type 2 diabetes diagnosis?
7. How can people with diabetes reduce their risk of retinopathy or other diabetes-related blindness?
8. Should I get new glasses if I was just diagnosed with diabetes?
9. I'm confused. Should I go to an optometrist or ophthalmologist for my eye exam?
10. I have higher than normal blood glucose levels, but haven't yet been diagnosed with diabetes. Should I be concerned about my eyes?

I have been diagnosed with diabetes. Will I go blind?

Although the leading cause of blindness up to age 70 is diabetes, most diabetes-related blindness is preventable. Act now and get a dilated eye exam, and learn how to control your diabetes. Early detection and treatment can prevent most diabetes-related blindness. People can go blind for many reasons, but as eye doctors, our job is to work with you to preserve vision throughout your life by detection of treatable conditions and education of what you can do to minimize your risk by lifestyle changes. Top

What is diabetic retinopathy?

Diabetic retinopathy is what happens when the retina undergoes changes due to chronic elevated levels of blood sugar. It can be stabilized by managing blood sugar levels, but without control, diabetic retinopathy can lead to blindness. I have patients who've had diabetes for 30 years without diabetic retinopathy. It's important to remember that the diagnosis of diabetes doesn't cause the diabetic retinopathy, high blood sugar levels do. The recommendation is to have your A1C level at seven percent or less to minimize vision problems and have a dilated eye exam once a year. The only way to detect diabetic retinopathy is through a dilated eye exam. Top

What is the biggest misstep patients with diabetes make?

Patients with good eyesight don't think anything is wrong with their vision and will not come in for a dilated eye exam. A patient can have 20/20 vision, but yet have retinopathy that is ready to burst. Just because your vision seems perfect to you, it does not mean you don't have a dangerous level of retinopathy. Top

How often should I go to the eye doctor if I have diabetes?

Once a year, although patients with high A1C levels may need to go more often. Also, any time you experience a noticeable change in your vision, you should make an appointment right away.Top

As a person with diabetes, what should I be prepared to share with my eye doctor on each visit?

I want to know my patient's current and past A1C level history. Your A1C level is the best single factor in knowing your risk for retinopathy. Top

Are there differences in how my vision will be affected depending on type 1 or type 2 diabetes diagnosis?

Although there is quite a difference in the way type 1 and type 2 is controlled, what matters is your glycemic control (blood sugar levels), not whether you are type 1 or type 2. Your A1C level, not what you need to do to maintain it, is the key in knowing your risk of diabetic retinopathy. Top

How can people with diabetes reduce their risk of retinopathy or other diabetes-related blindness?

There are three steps: A1C, A1C, A1C! Your A1C level is crucial, although smart changes in your meal choices and exercising are very important for your overall health as a person with diabetes. In addition, at any given A1C level, smoking and uncontrolled elevated blood pressure highly increases risk factors for diabetes-related vision problems. Top

Should I get new glasses if I was just diagnosed with diabetes?

Refraction (nearsightedness or farsightedness) can be altered quickly in patients with rapid A1C level fluctuations. So if new glasses are obtained right away, the prescription may significantly change in two or three weeks. If you need optimum vision during this fluctuation for work or driving, I would recommend discussing with your eye doctor purchasing an inexpensive single vision temporary pair of glasses, realizing that once your blood glucose stabilizes, you may need to purchase an additional pair of lenses at an additional cost. However, you could usually use the same frame. Top

I'm confused. Should I go to an optometrist or ophthalmologist for my eye exam?

You should see an optometrist or ophthalmologist who is familiar with diagnosis and treatment of diabetes and diabetic retinopathy. The doctor must give you a dilated eye exam. If significant diabetes related retinal problems are detected, you should receive a referral to an ophthalmological retinal specialist. You can find a qualified private-practice eye doctor near you at vsp.com. Top

I have higher than normal blood glucose levels, but haven't yet been diagnosed with diabetes. Should I be concerned about my eyes?

Early stages of retinopathy can occur prior to being diagnosed with diabetes. An annual eye exam is an important part of making sure your eyes stay healthy. If any diabetic retinopathy is detected, and properly reported to your primary care physician, the doctor may consider treatment for diabetes.Top

Note:Answers to previously asked questions will be posted here as they become available. Please note that due to number of requests, all questions may not be answered.