I just had my eye exam and I am glad that everything is fine. My ophthalmologist can not see any difference to a healthy eye and that after more than 20 years with D. This is a great relief for me because right before these examinations I get usually scared.
Since I very much appreciate the accuracy of my eye doctor I just wanted to tell about the steps of this examination procedure. I think every step is important and not one of these steps should be missing in your exams:
a) usual exam: reading different text sizes separately with every eye, asking questions about changes (day VS night vision etc) and about D.
b) eye drops for widening the pupil. 15 minutes of waiting time afterwards
c) eye exam by looking at the eyeground. Here the ophthalmologist not only uses his normal tools but uses an additional magnifier to see more details of the eyeground. You have to look in four to six directions with every eye so every part of the eyeground can be seen (upper left, mid left, lower left, upper right, mid right, lower right). At every direction you hold your eye steady so the doc can scan the area for abnormalities.
d) measurement of eye pressure
e) once in a year: testing the field of vision with a special device. You just look at one spot and then a point will appear somewhere in your field of vision. You press the trigger when you have seen the point. This way a map of your field of vision can be drawn.
Four years before when I was on NPH insulin I had much trouble with lows. These lows affected my vision because they are stressful for the central nerve of the eye. Back then my eye doc checked and has seen that everything is fine. But he really wanted to make sure that everything is okay and so he has send me to a hospital for a special eye exam. It is called angiogram of the eye. In this procedure a contrast liquid is injected into your vains and then a sequence of digital photos of the eyebackground is shot. These photos would reveal tiny and invisible bleedings that can start to happen before anything is visible in the eyeground. This exam showed that everything was healthy. After switching to NovoLog and Levemir my episodes with lows have been reduced dramatically and these problems totally dissappeared. I just mention this angiogram to point out that there are examinations beyond the usual that might be helpful to get a diagnosis.