All About Eyes: Importance of Dilated Exams

Diabetes is the leading cause of
preventable new-onset blindness in adults in the United States and worldwide. It’s
hugely important that patients with diabetes have regular eye screenings or regular
eye examinations to look for complications from diabetes in their
eyes even if they’re not noticing vision
symptoms and I can’t stress this enough. We see this everyday at the Joslin
Diabetes Center where patients come in who have not noticed
any change in their vision but can have very advanced eye disease and if we can get to those patients
early and treat them then we have a much better chance of
preserving their good vision. If we don’t get to them appropriately then
then, or in a timely manner then there’s a
much greater chance that those eye complications might proceed
unchecked and and patients might start to lose vision
from them. Dilation has always been the gold standard for a comprehensive or
complete retinal examination. By dilating the
pupil, you can get a view of the whole retina and be able to examine it in great detail. An un-dilated pupil gives
you a very limited look at the retina. The analogy is like looking into a room
through a keyhole verses opening up the door. The keyhole would be an un-dilated
exam. Opening up that door would be a dilated exam, you see much more of that room and we
would see much more of your retina. Many diseases that are not necessarily related to diabetes
may be evident and are eye examinations, so we may be
able to determine whether there is a risk of stroke and identifying embolism in the retina or whether there is hypertension or
renal disease. We recommend a dilated yearly eye exam
for everybody with diabetes. For patients with type 2 diabetes,
right after they get diagnosed with Type 2. The reason for that is that many
patients with type 2 diabetes, even though they’ve just been diagnosed
may have had the disease for a lot longer than they know about and so there can already be some vascular changes that occur that we want to know about. And in
patients with type 1 diabetes within five years or so are of their
diagnosis of diabetes or after puberty or after adolescence and again these examinations or having your
eyes examined with photographs or with dilated eyes is incredibly important because otherwise there’s a chance that we
might miss advanced eye disease in somebody who
still has good vision, who might not have any vision symptoms, but who really needs treatments.

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