Diabetic Eye Exam in Pregnancy: Timing and Follow-Up

What does the evidence say about diabetic eye exam in pregnancy?

1. ADA recommends a dilated eye examination ideally before pregnancy and in the first trimester for people with preexisting diabetes. Monitoring through pregnancy and up to a year postpartum is guided by the degree of retinopathy and the eye professional's recommendations. 1
2. Early diabetic eye disease can be symptom-free. Checking a glasses prescription or reading an eye chart does not replace examination for retinal disease. Tell the eye clinician about pregnancy and any previous eye findings or procedures. 2
3. Diabetic retinopathy affects blood vessels in the retina. New dark spots, floating streaks, or other vision changes can signal a problem needing prompt assessment. Symptoms that improve on their own still deserve discussion with the eye team. 3
4. Pregnancy-related changes in diabetes care require coordination between the eye and diabetes teams. Continue the glucose-management plan while seeking review of retinal findings; deliberately allowing high glucose is not a solution to an eye concern. 4
5. Vision change can also be an urgent maternal warning sign, especially with severe headache or other symptoms. Contact the pregnancy team promptly rather than assuming that every visual symptom comes from diabetic retinopathy. 5

When should diabetic eye checks be arranged?

• First trimester. Before conception or early pregnancy, establish the retinal findings and examination schedule.
• Second trimester. During pregnancy, keep planned visits and report new vision symptoms promptly.
• Third trimester. Later in pregnancy, review retinal findings and arrange the recommended follow-up after birth.

Questions to discuss with your care team