AFFILIATED EYE SURGEONS | DIABETIC EYE CARE
Diabetic Eye Care in Northern New Jersey
Diabetes is the leading cause of new blindness in working-age adults — but vision loss from diabetic eye disease is largely preventable with regular monitoring and timely treatment. Our
board-certified ophthalmologists provide expert diabetic eye exams and retinopathy management at three convenient Northern New Jersey
locations.
Annual Eye Exams Are Not Optional for People with Diabetes
If you have diabetes — Type 1, Type 2, or gestational — a comprehensive dilated eye exam is not just a recommendation. It is a critical part of your diabetes care. Diabetic retinopathy, the most common diabetic eye complication, causes no symptoms in its early stages. By the time vision problems become noticeable, significant and sometimes irreversible damage may already have occurred.
At Affiliated Eye Surgeons, our board-certified ophthalmologists have extensive experience in the diagnosis, monitoring, and treatment of diabetic eye disease. We work closely with your endocrinologist and primary care physician to provide integrated care — because protecting your vision requires managing both your eyes and your diabetes together.
Whether you have just been diagnosed with diabetes and need your first diabetic eye exam, are overdue for your annual dilated evaluation, or have been told you have early retinopathy that needs monitoring,
our team is here for you.
How Does Diabetes Damage the Eyes?
Diabetes causes chronically elevated blood sugar levels that, over time, damage small blood vessels throughout the body — including the delicate network of blood vessels that supply the retina, the light-sensitive tissue at the back of the eye. This damage produces diabetic retinopathy, the most common and serious diabetic eye complication.
As retinal blood vessels weaken, they can leak fluid and blood into the retina, causing swelling and distortion. The body responds by growing new, abnormal blood vessels — a process called neovascularization — but these new vessels are fragile, bleed easily, and can lead to scar tissue formation and, in severe cases, retinal detachment. The macula — the central region of the retina responsible for sharp, detailed vision — is particularly vulnerable to fluid accumulation, causing diabetic macular edema (DME), the most common cause of vision loss in diabetic retinopathy.
Diabetic eye conditions we monitor and treat:
- Diabetic retinopathy — damage to retinal blood vessels at any stage from mild nonproliferative to severe proliferative disease
- Diabetic macular edema (DME) — fluid accumulation in the macula causing central vision blurring and distortion
- Neovascular glaucoma — elevated eye pressure caused by abnormal blood vessel growth over the eye's drainage structures
- Cataracts — develop earlier and progress faster in people with diabetes
- Fluctuating vision — blurriness that changes with blood sugar levels, caused by lens swelling
- Cranial nerve palsies — diabetes-related nerve damage causing double vision or eye movement abnormalities
Stages of Diabetic Retinopathy
Mild Nonproliferative Diabetic Retinopathy (NPDR)
The earliest stage. Small areas of retinal blood vessel weakening (microaneurysms) develop. Vision is typically unaffected. No treatment is required at this stage beyond excellent systemic diabetes management and close monitoring. Annual or more frequent eye exams are essential to detect progression.
Moderate Nonproliferative Diabetic Retinopathy
More blood vessels are blocked or leaking. The retina may show flame-shaped hemorrhages, hard exudates (lipid deposits), and cotton-wool spots (nerve fiber layer infarcts). Macular edema may develop. Monitoring frequency increases to every 6 months. If macular edema involves the center of the macula, treatment with anti-VEGF injections is indicated.
Severe Nonproliferative Diabetic Retinopathy
Many retinal blood vessels are blocked. Blood supply to large areas of retina is compromised. The retina sends signals to grow new blood vessels. The risk of progression to proliferative disease is high — approximately 50% within one year. Close monitoring and often early treatment are recommended.
Proliferative Diabetic Retinopathy (PDR)
The most advanced and vision-threatening stage. New, fragile blood vessels grow on the surface of the retina and into the vitreous (the gel filling the eye). These vessels can bleed into the vitreous, causing sudden vision loss. Scar tissue formation can pull the retina away from the eye wall (tractional retinal detachment). Treatment — anti-VEGF injections, pan-retinal laser photocoagulation, and sometimes vitrectomy surgery — is required to prevent catastrophic vision loss.
Diabetic Eye Exam: What to Expect
A diabetic eye exam is more thorough than a standard eye exam. At Affiliated Eye Surgeons, every diabetic eye evaluation includes:
- Visual acuity testing — measures how well you see at distance and near, providing a baseline for tracking any changes over time.
- Dilated fundus examination — pupil-dilating drops are instilled and the retina is examined directly using specialized lenses. This allows visualization of the entire retina, optic nerve, and macula in detail. Dilation is essential — it cannot be replaced by photography or other technology alone.
- Intraocular pressure measurement — screens for glaucoma, the risk of which is doubled in patients with diabetes.
- OCT (optical coherence tomography) of the macula — high-resolution cross-sectional imaging of the macula detects and quantifies macular edema with precision not possible by clinical examination alone. Serial OCT measurements track response to treatment over time.
- Fundus photography — wide-field color photographs of the retina document the current status of diabetic changes and provide a reference for detecting progression at future visits.
- Fluorescein angiography (when indicated) — a fluorescent dye is injected intravenously and photographs capture blood flow through the retinal vessels, identifying areas of leakage, non-perfusion, and neovascularization. Used when the extent of disease needs precise characterization before treatment planning.
Treatment Options for Diabetic Eye Disease
Systemic Risk Factor Management — The Foundation of Everything
Anti-VEGF Intravitreal Injections
Laser Photocoagulation
Vitrectomy Surgery
No ocular treatment is as powerful as controlling the underlying diabetes. Maintaining HbA1c as close to target as safely achievable, controlling blood pressure (target below 130/80 mmHg), and managing cholesterol all significantly reduce the risk of diabetic retinopathy developing or progressing. Every percentage point reduction in HbA1c translates to a measurable reduction in retinopathy risk. We work collaboratively with your endocrinologist and primary care physician to ensure systemic control is optimized alongside your eye care.
Anti-VEGF (anti-vascular endothelial growth factor) medications are injected directly into the vitreous of the eye in the office under topical anesthesia. They block the growth factor that drives abnormal blood vessel formation and vascular leakage, reducing macular swelling and halting neovascularization. Anti-VEGF therapy is the gold standard treatment for diabetic macular edema and proliferative diabetic retinopathy. Medications include bevacizumab (Avastin), ranibizumab (Lucentis), aflibercept (Eylea), and faricimab (Vabysmo). Injections are administered at regular intervals — initially monthly, then spaced further apart as the eye responds.
Laser treatment has been a mainstay of diabetic retinopathy management for decades and remains an important treatment option. Focal laser treats specific leaking blood vessels in the macula to reduce macular edema. Pan-retinal photocoagulation (PRP) applies laser spots across the peripheral retina to reduce the oxygen demand that drives neovascularization in proliferative retinopathy. With the advent of anti-VEGF therapy, laser is now used less often as a primary treatment for DME but remains valuable for certain patterns of disease and as a maintenance strategy.
For patients with advanced proliferative diabetic retinopathy complicated by non-clearing vitreous hemorrhage or tractional retinal detachment, vitrectomy surgery may be required. The vitreous gel is removed from the eye, bleeding is cleared, and scar tissue causing traction on the retina is carefully dissected. Vitrectomy for diabetic complications requires a vitreoretinal surgeon with specialized training.
Why Choose Affiliated Eye Surgeons for Diabetic Eye Care?
Experienced Ophthalmologists with Diabetic Retinopathy Expertise
Managing diabetic eye disease requires experience, meticulous documentation, and the judgment to know when to watch and when to treat. Our
board-certified ophthalmologists have been caring for patients with diabetic eye disease across Northern New Jersey for decades, developing the expertise that comes from evaluating thousands of diabetic retinas over many years of practice.
Advanced Retinal Imaging Technology
We use OCT macula imaging and wide-field fundus photography to document and track diabetic retinal changes with precision. Serial imaging over time is the key to detecting subtle progression before it causes vision loss — and to confirming that treatment is working.
Coordination with Your Diabetes Care Team
Vision-threatening diabetic eye disease is a systemic problem that requires a systemic solution. We communicate proactively with your endocrinologist and primary care physician, sharing examination findings and reinforcing the importance of systemic risk factor control. Diabetes management and eye care should not happen in separate silos.
Reminders and Scheduling Support
Annual diabetic eye exams are easy to defer — especially when vision feels fine.
Our practice provides proactive annual recall to help diabetic patients stay on schedule with their dilated exams, because consistency is what catches early disease before it becomes vision-threatening.
Three Convenient Locations
With offices in
Morristown,
West Orange, and
Denville, we make it as convenient as possible for diabetic patients across Morris and Essex counties to stay current with their annual eye care — with no long drives or long waits.
Frequently Asked Questions
What is diabetic retinopathy?
Diabetic retinopathy is damage to the blood vessels of the retina caused by chronically elevated blood sugar levels. Over time, high glucose weakens retinal blood vessel walls, causing leakage, bleeding, and the growth of new abnormal vessels. It is the leading cause of new blindness in working-age adults in the United States and affects approximately one-third of people with diabetes. Early stages produce no symptoms — making annual dilated eye exams essential for everyone with diabetes.
How often should people with diabetes have an eye exam?
People with Type 1 diabetes should have a comprehensive dilated eye exam within 5 years of diagnosis and annually thereafter. People with Type 2 diabetes should have a dilated eye exam at the time of diagnosis and annually thereafter, since Type 2 diabetes is often present for years before detection and retinopathy may already exist at diagnosis. If diabetic eye disease is found, more frequent exams every 3 to 6 months may be recommended. Pregnant women with pre-existing diabetes should have an eye exam in the first trimester with close follow-up throughout pregnancy.
Can diabetic retinopathy be reversed?
Early nonproliferative diabetic retinopathy can sometimes improve or stabilize with excellent blood sugar and blood pressure control — without requiring eye-specific treatment. However, damage from advanced retinopathy — scar tissue, vision loss from macular edema, or tractional retinal detachment — cannot be fully reversed. This is why early detection and aggressive systemic diabetes management are so critical. Preventing progression is far more effective than treating advanced disease.
What are anti-VEGF injections for diabetic eye disease?
Anti-VEGF medications are injected directly into the vitreous of the eye to block the growth factor that drives abnormal blood vessel growth and leakage in diabetic retinopathy and diabetic macular edema. These medications have become the gold standard treatment for diabetic macular edema and proliferative diabetic retinopathy. They are administered in the office under topical anesthesia and are generally well tolerated. Multiple injections over months are typically required for the best outcomes.
What is diabetic macular edema?
Diabetic macular edema (DME) is swelling of the macula — the central part of the retina responsible for sharp, detailed vision — caused by fluid leaking from damaged retinal blood vessels. It is the most common cause of vision loss in people with diabetic retinopathy. Symptoms include blurring of central vision, difficulty reading, and image distortion. DME is treated primarily with anti-VEGF injections, sometimes combined with laser treatment. Early treatment produces the best visual outcomes.
Does controlling blood sugar help prevent diabetic eye disease?
Yes — significantly. Maintaining near-normal blood sugar levels dramatically reduces the risk of developing diabetic retinopathy and slows progression in those who already have it. Blood pressure control and cholesterol management also reduce risk. Every percentage point reduction in HbA1c is associated with a meaningful reduction in retinopathy risk. Managing diabetes systemically is the most powerful thing a patient can do to protect their vision long-term.
Can I lose my vision from diabetes?
Yes, if diabetic eye disease is not detected and treated. Diabetic retinopathy is the leading cause of new blindness in working-age American adults. However, vision loss from diabetes is largely preventable with annual dilated eye exams for early detection, aggressive systemic diabetes management, and prompt treatment when retinopathy progresses. The vast majority of patients who receive appropriate care maintain functional vision throughout their lives.
Is glaucoma hereditary?
Yes. Having a first-degree relative with glaucoma significantly increases risk — estimates suggest a 4 to 9 times higher risk compared to the general population. If you have a family history of glaucoma, regular comprehensive eye exams beginning in your 40s are strongly recommended, even if you have no symptoms. Glaucoma genes have been identified and genetic testing may be available for families with strong histories of early-onset disease.
What other eye conditions are associated with diabetes?
In addition to diabetic retinopathy, people with diabetes are at elevated risk for cataracts — which develop earlier and progress more rapidly — as well as glaucoma, with approximately double the risk of the general population. Fluctuating vision that changes with blood sugar levels is common, caused by swelling of the eye's natural lens in response to glucose changes. Cranial nerve palsies causing double vision can occur as a complication of diabetic neuropathy. A comprehensive annual diabetic eye exam screens for all of these conditions.
