I agree with you. Many optometrists don’t though… a lot of them like to pretend that they’re “eye doctors” which they’re really not… I take some issue with how the trend is for them to bend the truth on that one. An optometrist is an expert on vision correction with lenses. An ophthalmologist is a medical doctor. A lot of optometrists are now calling themselves “doctor” (they have a doctorate degeee in optometry) and telling their patients they are getting a medical exam by a doctor. I consider that inappropriate but it’s happening a lot now. Many of them are doing dialated retina exams…
I’ve been so lucky to have the optho doc I have. He does all my eye exams each year and has done 2 cataract surgeries that have left me with 20/20 vision in both eyes. They were done more than 3 years ago. I’m 70 now and am constantly amazed at how bright and sharp my vision at distance is. Better than any time prior to the surgeries, including when I was a teen. Couple a good surgeon with the correct lens and your eyesight will amazing.
The new Dr. I saw in January is an ophthalmologist and is qualified to do cataract surgery and whatnot. He was recommended to me by not one but two friends and he was quite thorough even though he was a bit rushed. Probably because he is obviously the Dr. people trust with their eyes around here. However if I had had to get new glasses based on the preliminary test his nurse performed then I would have thought I was going blind.
Mine have always been once a year. Exams are by an ophthalmologist if on my PCM Clinic/Hospital’s staff, otherwise by an optometrist. The exams also give me eyeglasses prescription every year paid by insurance; otherwise I have to pay for glasses exam every other year.
I show up at the opthalmologist’s , he asks me why I’m there, I say just because I’m diabetic, he checks my visual acuity and pressure, dilates my eyes, uses some gadget with lenses and a light to look at each retina for about 5 minutes, tells me my retinas are just fine, and when I should come back.
Yes, it sounds like you’re getting a full exam. I’d still ask the doctor: how are my blood vessels looking? I sometimes worry that they’re not telling me about what they consider a minor problem, but I’d consider a major one.
I had a doctor a couple of years ago show me pictures of my eyes. It was super cool. He was really surprised that there were absolutely no signs of retinopathy. It was actually pretty comforting to see the pictures. I can see why Tim35 requests it.
Your doctor doesn’t have to take pictures though. That’s not necessary. I’d still double check with the doc that there’s no sign of damage. If there is a sign of damage, then it’d be better to proactively manage it- unless they say otherwise. If they said otherwise, I’d probably double check with a second opinion though.
For diabetics your insurance probably covers the exam even without Vision coverage.
My Endo wants an exam every year. Am I bad - I often put it off up to 2 years between.
If you are in good control and no history of retina problems, every 2 years may be OK. Quoting the 2018 ADA Standards of Care:
If there is no evidence of retinopathy
for one or more annual eye exam and
glycemia is well controlled, then
exams every 1–2 years may be considered.
If any level of diabetic retinopathy
is present, subsequent
dilated retinal examinations should
be repeated at least annually by an
ophthalmologist or optometrist. If
retinopathy is progressing or sight threatening,
then examinations will
be required more frequently.
I do this once a year, it’s about the same deal. Critical is the opth’s close look at the optic nerve and IOP readings.
For me, the exam is paired with a visual field test, which tests vision across all parts of your retina for possible “blind spots” - it’s an sort of automated test that takes maybe 10 minutes staring in to a machine.
Once a year - but I did that even BEFORE being diagnosed with T1D.
And I have no vision plan, but it is covered by my medical plan (if you see an ophthamologist (who are MDs)) . The fact that I have multiple eye conditions (nearsightedness, astigmatism) in addition to T1D meant the medical plan had no problem paying for it,
As one gets older, even without T1D, there are multiple reasons to get a full retinal and eye exam - cataracts, glaucoma, macular degeneration ,etc. Many of these are highly treatable, especially if caught early and cause blindness if you wait too long. My sight is too important to me to fool around.
From what I’ve learned this depends not on the credentials of who does it, but rather on the code that they bill your insurance with… this is why we have, imo, a problem with optometrists conducting medical exams throughout the USA currently …
I’ve had Type 1 diabetes for 60 years. It wasn’t until my last yearly eye exam that the ophthalmologist told me she detected Stage 1 Diabetic Retinopathy. I asked what can be done for this. She said just keep your BG in range. Ha, easier said than done. Nothing more.
I decided I needed more information so I went to see a retinal specialist who did a number of tests I’ve never had before, including a visual field test. Still waiting for the results. He was curious why I had cataract surgery when I was 55, saying this was young. Then on top of the DR he also suspects I may have AMG (age related macular degeneration). He did give me PreserVision eye vitamin to take twice daily.
I wish I had pressed my ophthalmologist more on what she was noticing when she diagnosed me with DR.
I’m going to ask the ‘retinal’ doctor who HE RECOMMENDS for an ophthalmologist. Not so sure mine was really that good!
I’m glad you followed up with a retina specialist! That was smart!
We trust our doctors an awful lot, and it’s really hard for us to know when there’s a problem that the doctor isn’t properly addressing. I wish there was more open communication between doctors and patients.
At my last ophthalmologist appointment I was surprised to learn I was only having a retinal exam, which did not include a prescription for glasses. I’ve worn glasses since I was two years old (amblyopia) and since my T1D diagnosis, I’ve always had both done at the same annual appointment, with one bill. They (the doc’s office) are doing things differently now, they say because of insurance and billing, and I have to pay an additional fee for a prescription for glasses or make a second appointment.
My thought process was going down the path of alternating the years for each, one year I’d have the retinal exam and the following year I’d get a new prescription for glasses.
I’ve been re-reading Dr. Bernstein’s book, “Dr. Bernstein’s Diabetes Solution”, page 294 Kindle version, where he says in regards to exercise and eyes for retinal disease, that “Certain types of retinopathy are characterized by the presence of neovascularization, or very fragile new blood vessels growing from the retina into the vitreous gel that overlies it. If you strain too much, assume a head-down position, or land hard on your feet, these vessels can rupture and hemorrhage, causing blindness. If your physician or ophthalmologist identifies such vessels, you’ll probably be warned to avoid exercises requiring exertion of strong forces (e.g., weight lifting, chinning, push-ups, or sit-ups) and sudden changes of motion (e.g., running, jumping, falling, diving).”
So I’ll be having a retinal exam every year and either pay an additional fee or make another appointment for a new prescription for glasses.
Hi David,
I’ve had Type 1 diabetes for 60 years and was just recently diagnosed with diabetic retinopathy. In the last few months, I noticed lots of floaters going on in my left eye and saw a retinal specialist who said I have a vitreous hemorrhage in my left eye due to the fragile blood vessels breaking. The “black” floaters are actually blood from the broken vessels. My retinal doctor never told me to avoid exercises requiring exertion. I go back on the 24th of September and will ask him about this.
I’d get a retinal exam every year if I were you cause they can detect things that an optometrist (fits you for glasses) might not see.
DonR, How long have you been a Type 1 diabetic? Who and when were you diagnosed with AMD? Is there anything besides keeping your blood sugars under control that your eye doctor prescribed?
