Diabetes & Your Eyes: 6 Reasons to Get an Annual Eye Exam & How to Make It Happen

For individuals navigating life with type 2 diabetes, regular check-ups with a primary care physician or endocrinologist are commonplace. However, an often-overlooked component of comprehensive diabetes care is an annual visit to an optometrist or ophthalmologist. These specialized eye exams are crucial due to the fact that prolonged high blood sugar can inflict damage on the delicate blood vessels within the eyes, elevating the risk of serious eye diseases and potential vision loss. Conditions like diabetic retinopathy and diabetic macular edema are particularly concerning, though people with diabetes also experience higher rates of cataracts and glaucoma.

Approximately 90 percent of diabetes-related vision loss is preventable with timely diagnosis and treatment. Yet, alarmingly, only about half of individuals with diabetes adhere to recommended regular eye screenings. This gap in care underscores the need to understand and address the barriers that prevent people from prioritizing these vital exams.

Why People Delay or Skip Diabetes Eye Exams

Here are six common reasons why individuals with diabetes might postpone or forgo their yearly eye screening, along with strategies to aid stay on track with preventative care.

1. “My Vision Seems Fine, So an Exam Isn’t Necessary”

One of the most frequent misconceptions is that good vision equates to good eye health. However, in the early stages of diabetes-related eye conditions, You’ll see often no noticeable symptoms. As Alice Lorch, MD, MPH, explains, “Eye changes due to diabetes can happen slowly, over the course of years… They may not affect your vision until you already have irreparable damage in your eyes.”

This is why a comprehensive eye exam every year is essential, even in the absence of visual disturbances. These exams typically include vision testing, measurement of intraocular pressure, and a dilated eye exam – a procedure using eye drops to widen the pupils, allowing for a thorough examination of the retina. “Screening is preventive care,” emphasizes Adrian Au, MD, PhD. “The goal is to catch problems early, when treatment works best and vision can be preserved.”

2. Anxiety About Eye Exams

It’s understandable to perceive apprehensive about medical procedures, and eye exams are no exception. Concerns can range from discomfort during tests like the air-puff test for glaucoma to anxiety about potential diagnoses.

Open communication with your eye care professional can significantly alleviate these anxieties. “Answering questions and walking people through each step of the exam usually helps them feel much more at ease,” says Dr. Au. Here are a few additional tips:

• Before your appointment, jot down any questions or concerns you have.
• Bring a friend or family member for support.
• Practice relaxation techniques, such as deep breathing exercises, while waiting.
• Question your doctor to explain each step of the exam as it’s performed.

Remember, even if a diagnosis is made, treatments are available. While procedures like laser therapy and eye injections may sound daunting, they are generally not painful and can effectively unhurried disease progression and protect vision, according to Dr. Lorch.

3. Juggling Multiple Doctor’s Appointments

Managing type 2 diabetes often involves coordinating care with a variety of specialists – a primary care doctor, an endocrinologist, a cardiologist, and potentially others. It’s easy to feel overwhelmed by a packed schedule.

One approach is to consolidate appointments whenever possible. Increasingly, retinal screenings can be integrated into primary care visits. While traditional dilated eye exams remain the gold standard for detecting diabetic retinopathy, the American Optometric Association notes that screenings can now often be performed using retinal images captured by a primary care physician and remotely reviewed by an ophthalmologist.

“We can look at that photo, and if there’s anything we’re worried about, we bring that person in [to the eye clinic],” explains Dr. Lorch. “Otherwise, they can just obtain the photo taken again in a year.” Check with your doctor to see if retinal photography is an option for you.

4. Concerns About Cost and Insurance Coverage

The financial burden of healthcare can be a significant barrier to access, particularly for those without insurance. Research indicates that people without health insurance are less likely to receive annual diabetes eye screenings due to cost concerns.

“I encourage people concerned about cost to not skip care without first speaking to us,” says Dr. Au. “Many health systems have financial counseling services, payment plans, and assistance programs.” If you are uninsured, consider these options:

• Seek care at community clinics, county hospitals, or federally qualified health centers.
• Explore pharmaceutical assistance programs that may help cover treatment costs.
• Consult with a social worker or financial navigator to identify free or low-cost eye care resources.

Even with insurance, understanding your coverage is crucial. Diabetes eye exams are often covered under medical insurance, rather than vision insurance, as they are considered medically necessary. Don’t hesitate to contact your insurance provider to clarify your benefits, advises Dr. Lorch.

5. Limited Access to Eye Care Services

Geographic barriers and transportation challenges can make it difficult for some individuals to access eye care.

Telehealth offers a potential solution, with some eye health services now available virtually. You can search for eye clinics offering telehealth services or check with your insurance company for covered providers. Mobile eye care services, provided by some hospitals and community screenings at local health centers or schools, are also emerging options. The Health Resources & Services Administration website can help you locate community health centers in your area. Your primary care doctor may also be able to provide some basic eye care services.

6. Difficulty Finding a Comfortable Eye Doctor

Establishing a trusting relationship with your healthcare provider is paramount. If you haven’t found an eye doctor you feel comfortable with, don’t hesitate to seek a second opinion.

Ask your primary care doctor or trusted friends and family for recommendations. Look for a board-certified ophthalmologist or optometrist who specializes in diabetes-related eye screenings, accepts your insurance, and offers services like language interpretation if needed. After your first visit, reflect on your experience: Did the doctor explain things clearly? Did you feel rushed? Did you feel heard and respected? A good eye doctor will prioritize your comfort and well-being.

Prioritizing Your Vision Health

Regular eye exams are a cornerstone of diabetes management, offering a proactive approach to preserving your vision. If cost, anxiety, or accessibility have hindered your ability to receive the eye care you need, discuss these challenges with your healthcare team to explore solutions and ensure you receive the preventative care you deserve.