Diabetic eye exams: what to expect, when to book, and how they protect your sight

Diabetic eye exams explained

If you live with diabetes, a regular diabetic eye exam (also called diabetic eye screening) is one of the most important checks you can attend. Diabetes can damage the tiny blood vessels in the back of your eye (the retina), causing diabetic retinopathy and diabetic macular edema. These conditions often have no early symptoms, but early detection and treatment can prevent or reduce sight loss.

Eye screening vs regular eye test

A diabetic eye screening looks specifically for diabetes-related changes in the retina. It includes pupil dilation and retinal imaging to spot damage you might not notice yet. A standard sight test with an optician checks your vision and screens for many conditions, but it does not replace diabetic eye screening. You need both.

Who needs a diabetic eye exam and how often?

Age 12 and over with diabetes: You should be invited for screening regularly. Most people go every year; if your last two screenings showed no retinopathy, you may be invited every two years.

Type 1 diabetes: Have your first screening within five years of diagnosis.

Type 2 diabetes: Have your first screening as soon as possible after diagnosis.

Pregnancy with diabetes: Book an eye exam in the first trimester and follow your clinician’s advice on additional checks.

Children under 12: Routine screening is not usually needed because significant retinopathy is rare in this age group.

What happens during a diabetic eye exam

The appointment usually takes around 30 minutes.

Vision check: You’ll read letters on a chart to assess your visual acuity.

Pupil dilation: Eye drops widen your pupils for a clear view of the retina. They may sting briefly and cause light sensitivity and blurred near vision for a few hours. Do not drive after the drops. Bring sunglasses and consider asking someone to accompany you.

Retinal photographs: A camera takes images of the back of each eye. There’s a brief flash; nothing touches your eye and it shouldn’t be painful.

Additional tests if needed:

OCT scan (Optical Coherence Tomography): A quick, painless 3D scan that shows the layers of your retina and can detect fluid or thickening at the macula.

Fluorescein angiography (occasionally): A dye test that highlights leaking or blocked blood vessels for detailed assessment.

Eye pressure measurement: To screen for glaucoma risk when indicated.

Understanding your results

You’ll receive a letter with your results, typically within a few weeks. Results generally fall into three categories:

No retinopathy: No diabetes-related changes seen. You’ll be invited again in 1–2 years.

Background/minor changes: Small changes are present, but your sight may not be affected now. You’ll be monitored more closely, usually in 12 months or sooner as advised.

Referable changes: Damage that could affect your sight (such as proliferative retinopathy or macular involvement). You’ll be referred to a specialist for further tests and treatment options.

When to seek help urgently

Do not wait for your next screening if you notice:

Sudden vision loss or a dark curtain over your vision

A sudden increase in floaters or flashing lights

Blurred or distorted central vision

Eye pain or redness with vision changes Contact your GP, optometrist, or urgent eye care service promptly.

How to protect your eyes between screenings

Keep blood glucose in your target range as consistently as possible.

Manage blood pressure and cholesterol.

Do not smoke; seek support to quit if needed.

Eat a balanced diet and stay physically active.

Take diabetes medications as prescribed and attend all routine checks.

Keep up with both diabetic eye screening and regular sight tests.

Why this exam matters

Diabetic retinopathy is a leading cause of preventable sight loss. Because it can progress silently, retinal photographs and scans often detect changes long before you notice symptoms. Catching problems early gives you more treatment options and better outcomes.