How to choose an ophthalmologist if you have diabetes

If you haven’t visited an ophthalmologist for a few years, you can either schedule an appointment with your old doctor or, if you’ve moved or changed insurance policies, you might want to schedule an appointment with someone new.

A good vision care team, particularly for people with diabetes, is important. Finding the right provider will take some time and research, and it is best done before an emergency arises. So, start your search well before you’re due for a checkup.

Things to consider when making your selection, include:

• The doctor’s skills and credentials, safety precautions and technology utilized
• Proximity of the office to your home or workplace

• Office hours, accepted insurance plans, fees, payment policy and ability to accommodate emergencies.
• A comfortable office environment.
• You want a vision care team you like. They should be willing to listen to your concerns, answer your questions, and explain what they’re doing and why.
• If possible, you also want an ophthalmologist who has experience working with people with diabetes.

An obvious place to begin your search is to ask your friends. Your doctor, Certified Diabetes Educator or pharmacist may also have a list of ophthalmologists who work with people who have diabetes.

• Call the department of ophthalmology or optometry at a nearby hospital or university medical center.
• Contact a state or county association of ophthalmologists or optometrists. These groups may have lists of eye care professionals with specific information on specialty and experience.
• Contact your insurance company or health plan to learn whether it has a list of eye care professionals who are covered under your plan.
• The American Academy of Ophthalmology coordinates Find an Eye MD, an on-line listing of member ophthalmologists practicing in the United States and abroad.
• The American Optometric Association offers Dr. Locator, an online listing of member optometrists.
• The International Society of Refractive Surgery maintains comprehensive directory of surgeons around the world who are currently performing refractive surgery.

Compare your list to the list of providers with whom your insurance company does business. Unless you can personally afford a doctor who does not participate in your insurance plan, there’s no point in finding a great ophthalmologist who doesn’t take your insurance.

After you’ve narrowed down your list, hit the Internet. Many ophthalmologists also have websites which will give you information on where they went to school, how long they’ve been in practice, the types of services they offer, if they attend regular conferences or have continuing education, what their treatment philosophy is, even pictures of their office and facilities.

When you call the office, does the receptionist sound professional and courteous? Ask if they are accepting new patients and ask if they have experience working with patients who have diabetes? Are they able to answer your questions? If they seem reluctant to answer your questions that could be a sign of potential trouble in the future; best to move on to your next choice.

When you schedule your appointment be sure to ask what their cancellation policy is. If you do have to cancel your appointment, be sure to do it in the appropriate time frame or you may be charged – not a good way to start a relationship!

The doctor will provide you with intake forms that record your medical history. This may include information about any medical conditions or illnesses you have (or had), medicines you take and allergies you have.

Be sure to tell them you have diabetes, how long you’ve had it, how you control it, your current A1C level, as well as problems (dental or physical) you’ve had recently. Your eye care team should follow up on these issues every visit.

Your ophthalmologist should have your physician's name and phone number so they can contact your physician with any concerns or questions about your treatment.

What to expect at an eye exam

1. Visual acuity test. This eye chart test measures how well you see at various distances.
2. Dilated eye exam. Special drops are placed in your eyes to widen, or dilate, the pupils. This allows your doctor to see more of the inside of your eyes to check for signs of disease. A magnifying lens is used to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
3. Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional checks your retina for early signs of the disease, including:

• Leaking blood vessels.
• Retinal swelling (macular edema).
• Pale, fatty deposits on the retina.
• Damaged nerve tissue.
• Any changes to the blood vessels.

If your eye care professional believes you have macular edema, they may suggest a fluorescein angiogram. In this test, a dye is injected into your arm and pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

Based on the results of your eye exam your vision care specialist may schedule follow-up appointments to re-evaluate your condition or treat your eye disease.