Diagnosis of Diabetic Retinopathy
Diagnosis of diabetic retinopathy requires a thorough examination of the eyes to identify damage caused by prolonged high blood sugar levels. As diabetic retinopathy often develops gradually and without symptoms in its early stages, regular screening is vital for all individuals living with diabetes. Early detection can help prevent vision loss and guide timely treatment interventions.
Routine Eye Examinations
People with diabetes are advised to undergo:
Annual dilated eye exams, which allow ophthalmologists or optometrists to inspect the retina and optic nerve in detail
These exams are essential, even if vision seems unaffected, as damage can occur silently
In some cases, exams may be required more frequently depending on individual risk or severity of existing eye disease
Dilated Fundus Examination
Special drops are used to widen the pupils, providing a clear view of the retina
A slit-lamp microscope or ophthalmoscope allows the specialist to detect signs such as:
Microaneurysms
Haemorrhages
Leaking blood vessels
Retinal swelling (macular oedema)
New vessel growth (neovascularisation)
Optical Coherence Tomography (OCT)
A non-invasive imaging test that provides cross-sectional views of the retina
OCT detects fluid build-up, thickness, and swelling, particularly useful for diagnosing macular oedema
Helps monitor disease progression and response to treatment
Fluorescein Angiography
Doctors inject a special dye into the arm, which then travels through the bloodstream to the eyes
A camera takes rapid photographs of the retina, revealing blood flow patterns and pinpointing leaks or blockages
Doctors typically use this test to assess severity or plan laser treatment
Classification of Diabetic Retinopathy
Doctors categorise the condition into stages:
Mild Non-Proliferative Retinopathy – early signs like microaneurysms
Moderate to Severe Non-Proliferative Retinopathy – increased blood vessel damage and bleeding
Proliferative Diabetic Retinopathy – new abnormal blood vessels form, posing serious risk of vision loss
Diabetic Macular Oedema (DMO) – swelling in the central retina, which can occur at any stage
When to Screen | Diagnosis of Diabetic Retinopathy
Type 1 Diabetes: Start screening 5 years after diagnosis
Type 2 Diabetes: Screen at the time of diagnosis
Pregnancy: Women with diabetes should have an eye exam before or during early pregnancy, then again later in pregnancy
In summary, diagnosis of diabetic retinopathy involves a mix of detailed retinal assessments and imaging. Consistent screening ensures early intervention, preventing irreversible damage and maintaining eye health in people with diabetes.
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