How Often and Why Should You Get Screened for Diabetic Retinopathy?

✅ Medically reviewed by Dr Sharon Heng

Diabetic retinopathy is a complication of diabetes that affects the eyes. It occurs when high blood sugar levels damage the tiny blood vessels in the retina—the light-sensitive tissue at the back of the eye. Over time, these vessels can leak, swell, or become blocked, impairing vision and potentially leading to blindness if left untreated.

What makes diabetic retinopathy particularly concerning is that it often has no symptoms in the early stages. Many individuals are unaware they have the condition until it has progressed significantly. That’s why regular screening is not only important but essential for anyone living with diabetes.

Why Screening Is Critical

Early detection of diabetic retinopathy allows for timely intervention. When the disease is caught early, treatment can help preserve vision and slow progression. Screening plays a preventive role by allowing healthcare providers to monitor subtle changes in the retina before symptoms become noticeable.

Untreated diabetic retinopathy can lead to serious complications, including diabetic macular edema (swelling in the central retina), retinal detachment, or even total vision loss. Since the damage is often irreversible, consistent eye screening remains one of the most effective tools in preventing blindness caused by diabetes.

Recommended Screening Frequency

The frequency of diabetic retinopathy screening varies depending on the type of diabetes and the individual’s age, health status, and previous screening results. For most patients:

• Type 1 Diabetes: Screening should begin within five years of diagnosis, as the condition often starts in younger individuals.

• Type 2 Diabetes: Screening is recommended at the time of diagnosis because the disease is usually present for some time before being detected.

• Pregnant Women with Diabetes: They should have an eye exam before pregnancy or during the first trimester, with follow-up throughout the pregnancy as needed.
  

For individuals without retinopathy, eye exams are generally recommended every 1 to 2 years. If diabetic retinopathy is present, the frequency increases to every 6 to 12 months, or more often if advised by an eye specialist.

The Screening Process: What to Expect

A diabetic retinopathy screening is a straightforward and non-invasive procedure. It usually involves:

1. Pupil Dilation: Eye drops are used to widen the pupils so the retina can be viewed more clearly.

2. Retinal Imaging or Examination: A fundus camera takes photos of the retina, or an ophthalmologist uses special lenses to examine the retina directly.

3. Assessment: The images or findings are reviewed to detect any abnormalities such as microaneurysms, hemorrhages, or swelling.
   

This process typically takes less than 30 minutes and does not require any preparation apart from arranging for someone to drive you home if dilation affects your vision temporarily.

Who Should Prioritise Screening?

Anyone with diabetes should prioritise regular eye exams, but some individuals may face higher risk factors for diabetic retinopathy. These include:

• Long-standing diabetes (over 10 years)

• Poor blood sugar control

• High blood pressure

• High cholesterol

• Smoking

• Pregnancy in diabetic patients
  

The longer someone has diabetes and the less controlled their blood sugar levels, the greater their risk for developing retinopathy. Screening is even more important for individuals in these high-risk groups.

What Happens After Screening?

If the screening detects no signs of diabetic retinopathy, you’ll typically be advised to return for another screening in one to two years. However, if early signs are present, your doctor may refer you to a retinal specialist. Depending on the severity, treatment options may include:

• Laser therapy to seal leaking blood vessels

• Anti-VEGF injections to reduce swelling

• Vitrectomy in advanced cases to remove blood or scar tissue from the eye
  

Managing diabetic retinopathy also involves tight control of blood glucose, blood pressure, and cholesterol. Patients are usually encouraged to maintain a healthy diet, exercise regularly, and follow their diabetes care plan closely.

The Role of Technology in Screening

Recent advancements in digital retinal imaging and artificial intelligence are making diabetic retinopathy screening more accessible. In some clinics, AI tools can now screen and provide an immediate risk assessment, speeding up the referral process for those who need care.

Additionally, mobile screening units and tele-ophthalmology platforms are helping reach patients in remote areas, ensuring that no one misses out on essential eye care due to location or mobility issues.

Conclusion

Diabetic retinopathy is one of the leading causes of vision loss among working-age adults, but it’s largely preventable through regular screening and early treatment. The fact that it often progresses without noticeable symptoms is what makes routine eye exams so crucial.

Whether you’ve recently been diagnosed with diabetes or have been managing it for years, don’t wait until your vision is affected. Talk to your healthcare provider about scheduling a diabetic retinopathy screening and make it a routine part of your diabetes management plan. Protecting your sight is protecting your quality of life.