A routine eye examination can sometimes reveal far more than whether a patient needs a change in their glasses. A 55-year-old woman was referred to Queensland Eye and Retina Specialists (QERS) for retinal assessment following a routine eye examination with her optometrist. She had a 26-year history of type 1 diabetes and hyperlipidaemia, with a most recent HbA1c of 8.4%.
Importantly, she had excellent aided visual acuity in both eyes, measuring 6/6- in the right eye and 6/6 in the left eye.
Despite her good vision, dilated fundus examination and ultra-widefield imaging revealed significant diabetic retinal changes. The right eye demonstrated moderate non-proliferative diabetic retinopathy (NPDR), while the left eye had progressed to severe NPDR, with multiple peripheral retinal haemorrhages, venous engorgement, and macular microaneurysms with associated hard exudates.
Fluorescein angiography further revealed areas of significant capillary dropout and associated ischemia in both retinae.
Good vision does not always mean healthy retinas
This case highlights an important message for patients: significant retinal disease can develop before a patient notices any change in their vision.
Visual acuity alone does not provide a complete assessment of retinal health. Dilated retinal examination, supplemented by retinal imaging such as ultra-widefield photography, OCT and fluorescein angiography where indicated, can identify retinal changes at an earlier stage and help guide appropriate monitoring and referral.
For this patient, a routine eye examination provided an opportunity to identify clinically significant diabetic retinopathy despite her excellent visual acuity.
World Sight Day 2026: Love Your Eyes
World Sight Day is an opportunity to remind patients that looking after their eyes is an important part of looking after their overall health.
For people living with diabetes, regular eye examinations are particularly important. Diabetic retinopathy can progress silently, and early detection allows patients and their healthcare team to intervene before vision is significantly affected.
The take-home message:
You don’t have to notice a change in your vision for there to be a change in your eyes.
This World Sight Day, #LoveYourEyes — make regular eye examinations part of your routine, particularly if you live with diabetes or other conditions that can affect your eye health.
At QERS, we work closely with optometrists and GPs to provide comprehensive retinal assessment and ongoing management for patients with diabetic eye disease.