Eye exam

So, I haven't had my eyes checked for about 3 years. I'd been putting it off, since I haven't had insurance. The last couple of times, I'd gotten it checked at an optometrist who never noticed any problems. I recently got coverage through my wife, so I got a check up from a legit opthamologist. He dilated my pupils, took a lot of pictures etc.

To give some background, I've been T1 for ~27 years. I've never been entirely reckless, but for the most part, my control has not been good. Avg A1C probably about 8 with much deviation. Over the last couple years, I've been trying to maintain tight control with a LC diet, and improved diligence. I'm Having some success.

The eye Dr pointed out some mild cataracts, and small spots of blood. One was a concern, because it is near the macula. He reassured me, though, that my eyes are in good shape for a long-term diabetic. Also, my near-sightedness and astigmatism had disappeared, perhaps due to improved BG. He said that the problems may correct themselves.

These seem to be my first long-term complications. I'm not panicking, but feel more than a little concerned. I like to think that they are reversible. Anyone have tips on helping your eyes heel? Any advice? Thanks.

My advice is to go to a retinologist also who will do an even more thorough exam and give you a better assessment about what to do about the macular thing. Research doctors online and go to the best one in your area at a good research hospital. And make sure you go once per year or however often they tell you to, to the doctor who will treat you from now on for the exam where your eyes are dilated and everything is looked at. A retinologist uses a very bright light to look at everything.

I read somewhere that tight control after a higher a1c can cause retinopathy, I'm not sure why or if that is the case for everyone. My blurry vision hasn't resolved completely since dka although it has improved greatly, but nothing can be found except for a shadow of cataract which they said is so minor it's not worth mentioning.

My most recent doc said to have this exam every year.

Another thing she said was not to stop reading etc. I read a lot online and was worried this is straining my eyes... she said it's like the brain.. we have to keep using it.

As for what to do, I think you need to figure out what is causing the blood spots first. Did your doc say anything about that?

I was using an eye drop for dry eye for a few years before D for severe dry eye and I sleep with a moisture goggle at night, using the drops beforehand. I now added in a drop with acetyl carnocine and cinammon supplements- I read that they can help prevent cataracts. Some people say these drops have reversed cataracts in their dogs, dogs with D progress very rapidly to cataracts. I also wear sunglasses, motorcycle glasses, most of the time outside.

Here is a link I'm glad I found, think it will help.


Sam, I have seen the same opthamologist for almost 30 years. He has noted very small changes in my eye through the years: I have a tiny cataract in my right eye, which he said was due to aging. I have always had astigmatism and near sightedness, since early childhood (pre-diabetes years: wore those (heavy lens grandma cat eye harlequin frame classes at 5, YUCK). Now I have old-age farsightedness as well. I am corrected to 20/25 with contacts, but may need a change to accommodate the aging eye, as I have had the same prescription for contacts for 6 years: I am noticing I need to hold books, my smartphone, out too far with the current contacts.He saw a "tiny spot that is not worth mentioning" ( his description) on my left eye 2 years ago, which had resolved itself by the next annual visit.. If you trust his judgement, I would stay with his suggestions. Mee's link and her comments are on point as well.

God Bless,

FWIW, I have had laser, 3 vitrectomies and cataracts all within a period of 3 years. For the last eight years my eyes have been stable and healthy. So when things go bad (and when they did it REALLY freaked me out), there can be a path forward.

My problems started with neovascularization (new blood vessels forming and leaking). Keep up your good control. You did not mention what the eye DR, did. If he/she used a lot of gadgets to profile your eyes/retina then that is good. There will be a baseline to monitor for future changes.

I use a retina Dr. who specializes in diabetes care and visit twice a year. Don't know if that is necessary but it is comforting.

I had had "stable" non proliferative retinopathy for about 5 years. over a period of 3 months I dropped my A1c from 8.1 to 7.3 and with my next exam with the retina specialist I have developed "cotton wool spots". She tells me that, yes in fact you can cause problems if you drop too fast and you already have retinopathy. I was shocked to say the least.

A supplement I have read a lot about and have taken sporadically over the years is Pycnogenol. Apparently it used extensively in Europe for diabetic retinopathy and I first heard about it when I attended a diabetes clinic at Joslin. It is very expensive especially for the doses they've used in the European studies.

re: meee

Thanks for the advice and the link. I've also heard somewhere about tighter control and retinopathy. Very interesting. The doc didn't explain what caused the blood spots, other than saying they were typical for diabetics.

I never wear sunglasses or use eyedrops. Will definitely start with sunglasses when it is bright out.

Thanks Brunetta. Glad the spot went away. This is what I'm hoping for.

The Dr seems good. I didn't ask any questions, because I wasn't expecting any of this. I'll try to be nice to my eyes for 3 months, and go back to him. If things get worse, I'll find a retinologist.

The eye Dr. made me put my face in 3 machines that took pictures. At least 1 shot air into my eyeballs. He showed me very large, detailed pictures. It was pretty impressive.

Sorry to hear that. I've tended to hover around 8, but in the mid - high 6's lately. My blood pressure also went up with my tighter control. Never paid that much thought to my eyes until now. I've always had floaters, but never made the association. Guess there are some things about D you learn the hard way. Good luck to you.

I saw the same opthamologist for many years and she spotted two cataracts one corrected now and some background retinopathy. The retinopathy comes and goes some visits it is there others it is not. My suggestion is don't panic, go back in a year or whatever they scheduled and keep doing what you are doing.

Thanks, Rick. Good to know.I'm not panicked. Just yet another thing to think about. If anything, I'm glad I caught this early.