I need to get an eye exam soon and am wondering if it’s worth the hassle and cost of having a full retinal exam done. For background, I’ve never needed glasses or contacts, and as such I don’t have vision insurance.
I last had a full retinal exam about 1.5 years ago. Since then my A1c has been at or below 6.0. According to my endo, regular eye exams aren’t necessary for me at this point given my recent diagnosis (2 years ago) and good control.
So I wanted to see what other people do. I browsed some older topics on this forum and saw a mixed bag of answers. So I thought it would bring the topic up again and see what, if anything, has changed.
What do you do? How often do you get a full retinal exam?
I get a full dilated eye exam performed by an opthamologist once per year. While good blood glucose control will help minimize the chance of complications, it is not a guarantee. I prefer that this this check be made yearly. As is the case with most health conditions, earlier detection often improves the prognosis.
I had a full retinal exam the first two years and a half after diagnosis - One was for a baseline. In the second one the doctor thought there was negative change, so had me return in 6 months. At the third, they decided there was no cause for alarm, and put me back on “normal” annual appointments. The last 2 years, I’ve had full dilated exams (that have been good), but no retinal imaging.
I don’t have vision insurance, but my ophthalmologist appts are covered under my medical plan. Since you are recently diagnosed and well controlled, you may not need a yearly exam, but maybe every 2-3 years, or immediately if you notice any changes. What does your endo recommend?
I have a yearly exam, but have 50+ years with T1D. I had many laser treatments already done on my eyes, but pretty stable the last 25 years.
In this case I am a bad diabetic. I’ve had diabetes for 26 years and I have only had a few exams done the most recent one in January (no damage yay). It was a dilated exam and I actually do wear glasses but as far as we could tell my prescription hasn’t changed at all in 15 years. Although when my mom realized that I couldn’t read street signs from the car when I was 12 everyone freaked out and I got an emergency appointment with a specialist where she didn’t see anything wrong with me except a little nearsightedness.
However if I was worried at all about my sight I would take the time and the expense to go to the eye Dr. , which I believe cost me $100+ for the exam alone.
Additional visits if any symptoms arise that may be neuro or eye related. It is my experience that a full eye exam from an experienced ophthalmologist has the ability to diagnose (or conversely to rule out) a large number of issues not all of which are eye related.
Once a year also. My vision changes with my A1c, so I make sure to get the pressures checked too. The entire exam is classed under"Diabetic Eye Exam" and is covered under my medical policy thanks to ObamaCare. I just need to get the referral first from my primary or Endo so the medical insurance company will pay.
A full eye exam with dilation has always been a high priority for me. I’ve read multiple posts that state catching retinopathy early can make a huge difference long term.
I highly value my eyesight (as I’m sure we all do), and this particular complication is probably the most frightening for me. I’d rather just get it checked every year.
Once - year dilated exam with an ophthalmologist not an optometrist. I personally don’t think imaging is necessary unless they’re noting abnormalities. Normal is normal.
In my personal opinion the imaging originated as a gimmick that allowed optometrists (not ophthalmologists) to bill for a medical screening… it has value if they’re tracking issues but not if they’re just photographing a normal retina IMO
If anything comes up even minor, I like the ability to be able to look in previous years and see if it showed up previously or is a new issue. The ability for me to look over the Doc’s shoulder and see the images myself is worth quite a lot to me.
Twice a year every year. My mom was blind a a result of diabetes and I am crazy worried about it. Thankfully, I do not have any symptoms, it does not matter, twice per year. I woudl go 4 times a year if they let me. By the way if an ophthalmologist does the full check it is most likely a medical not vision insurance claim.
If an optometrist does it, it is likely a vision claim.
Whether imaged or not, you should have a baseline optic nerve exam (requires dilation) and a visual field check. Ideally every year, but if you’ve never done this before, get an exam and a baseline.
I also get an exam once a year by an ophthalmologist. It is covered under my medical plan as he is a MD. The complete exam with photos every 5 or 5 years for a base line comparison. I was told back in 1970 to have an eye exam every year and I still do.
I was recently lectured about this. I didn’t want to pay for an eye exam, and didn’t, for several years. The Doc told me, though, that if we catch complications early, then they might be treatable. However, if it drags out, there will not be anything they can do about it. That worked on me. I went in. Normal results.
I’ve been through SO MANY dilated eye exams over the past 35 years as a T1.
In my case - I don’t know if this is true for everyone - the retinal exam is covered by my health insurance and NOT by my vision insurance. This is true if an opthalmologist does it at least. (I know that most optometrists have fancy-pants cameras these days too and it would not surprise me if they billed to vision insurance.)
As Sam19 points out, the boundary between optometrist and opthalmologist is not always so clear. In my case the optometrist measures me for glasses (refraction) and the opthalmologist does the slit-eye exam. I do not get refraction done at the opthalmologist and I do not get a slit-eye exam at the optometrist.
Current recommendation from ADA standard of care is “Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist within 5 years after the onset of diabetes.”.
Your conclusion meshes with the ADA recommendation.
I agree with Sam19 that the fancy-pants cameras are not necessary and are unnecessary frills. Having talked to a lot of opthamologists over the years they all tell me the most sensitive and necessary test is the slit-lamp as a qualified and experienced opthamologist peers into your eye and looks at the back. The cameras probably do have some value for long-term tracking. The optometrists, I don’t think they are necessarily qualified to do the more sensitive slit-lamp exam.
