Eye background examination for diabetes | Ocular fundus examination

Eye background examination for diabetes

Although diabetes mellitus is a disease that primarily affects the pancreas and thus the body’s sugar metabolism, it is also a disease of the liver. However, this disorder affects the entire body and all organ systems, including the eyes. The main consequential damage that diabetes causes to the eye is the development of cataracts, diabetic retinopathy and secondary or neovascularisation glaucoma.

Diabetic retinopathy, in turn, can be divided into two subforms, the proliferative and the non-proliferative form. In this case, the blood sugar levels, which are often poorly adjusted over many years, and the blood pressure, which is also too high, cause minor damage to the blood vessels in the back of the eye. These supply the retina, which can suffer damage and die without sufficient oxygen.

Due to the small lesions that have developed in the vascular wall, small bulges, so-called microaneurysms, form there, which can burst and cause bleeding in the retina. This stage of retinopathy is called non-proliferative. In a more advanced stage, new small blood vessels are formed in the retina, since the retina is dependent on an adequate supply of oxygen, but the defective vessels can no longer transport the blood everywhere.

However, these fresh vessels are very weak and vulnerable, which further increases the risk of bleeding into the retina. If the blood even gets into the vitreous body of the eye itself, vision is severely impaired. Despite the severity of the disease, those affected do not notice any symptoms for a long time at first.

Sometimes the vision is slightly reduced and vision becomes a little blurred. When the first symptoms appear, it is then usually too late to effectively combat the progress of the disease and the consequential damage must be treated first and foremost. Therefore, it is extremely important for diabetics to take conscientious note of the regular check-ups of the ocular fundus carried out by the attending physician, as prevention is the best way to avoid damage to the eye.

Cataracts is a gradual clouding of the lens, which hinders the light entering the eye and reduces vision. A cataract in old age, i.e. over 65 years of age, is quite normal. In diabetics, however, it often develops much faster and earlier. The first symptoms can be dull and blurred vision, increasingly poor night vision, sensitivity to light and halos around bright light sources. The clouding does not cause pain, so the gradual process is hardly noticed by many people affected, or only very late.

Next steps

For some of the diseases, further examinations are then required, such as a vascular imaging (fluorescence angiography) or an ultrasound examination.

Driving a car after an ocular fundus examination

After a retinal examination, the patient should not drive a car for a certain period of time and should not actively participate in public traffic. This is because the pupils are no longer able to adapt to the incident light of the surroundings and to seeing near and far due to the dilation of the pupils by medication. Vision becomes blurred and the eye is more sensitive to light than normal.

As a result, one’s vision is much worse than normal and one is often unable to judge distances and speeds correctly. As a rule, however, the effect of the pupil-dilating eye drops should have disappeared after about three to five hours and the patient can once again participate fully in traffic. The dilation of the pupil for the examination naturally has no further consequences for the eye or vision.