The Practical Aspects

The Amsler Grid Test

Diabetics can scare away the eye problem by keeping their blood sugars normal. But comprehensive eye exams are needed every year, or as directed by your physician to protect your vision. The most dangerous threats to vision in diabetes give little or no warning. Only by direct examination with an ophthalmoscope can these early changes be seen and treatment started before sight becomes seriously threatened.

Some physicians are excellent at examining the retina and spend the extra time required to visualize the entire retina. But all the doctors may not be thorough with the eye examinations in diabetics thus leaving scope for the changes in retina to go undetected.

In a 1982 report, Dr. Elliot Sussman and others found that serious errors in examining the retina were made by 52% of internists, 33% of diabetologists, 9% of general ophthalmologists, while retina specialists made none.

Discuss with your own physician whether and when you need to see an ophthalmologist or retina specialist. An experienced ophthalmologist may at times, only pick up warning signs to indicate that treatment of the eye is needed

Do It Yourself!

At times, someone who has diabetes can detect changes in their vision that warn of problems. These changes can be found using a simple Amsler grid and testing with this helps to detect vision changes caused by poor control, macular edema, or a detached retina. Health professionals to detect eye problems use the grid, but it only detects problems in the macula and cannot check other regions of the eye. Anyone who has been told they have significant eye changes caused by diabetes should test each eye daily. A doctor should be seen immediately if you notice any changes in your vision.

Using the Amsler grid:

1. Print out the square to the left on white paper.
2. Wear your reading glasses and cover one eye.
3. Focus on the center dot for one full minute.
4. While looking directly at the center, be sure that all the lines are straight and clear, and all the small squares are the same size.
5. Repeat the test in the other eye.
6. If any lines or squares appear distorted, wavy, blurred, discolored, or otherwise abnormal, call your eye doctor right away.
7. In healthy eyes the lines are straight.

The Amsler grid will not detect PDR, most preproliferative changes and other types of damage that may threaten vision, nor is it useful for detecting any of the early changes found in BDR. It cannot replace routine eye exams. One should remember that a normal Amsler grid test does not rule out the presence of retinopathy that can threaten the vision. Only regular eye exams can do this.