Diabetes is the leading cause of blindness in working-age Americans.  Approximately 29 million Americans age 20 or older have diabetes.  But many, almost one-third, don't know they have the disease and are at risk for vision loss and other health problems.  

Diabetic eye disease, a group of eye problems that affects those with diabetes, includes diabetic retinopathy, cataracts and glaucoma.  The most common of these is diabetic retinopathy, which affects 5.3 million Americans age eighteen and older. Diabetic retinopathy is a potentially blinding condition in which the blood vessels inside the retina become damaged from the high blood sugar levels associated with diabetes.  This leads to the leakage of fluids into the retina and the obstruction of blood flow.  Both may cause vision loss.  More than one-third of those diagnosed with diabetes do not receive the recommended vision care and are at risk for blindness.  Often early symptoms are unnoticed, therefore your vision may not be affected until the disease is severe and less easily treatable.

Once you are diagnosed with diabetes, schedule a complete dilated eye examination with your Eye M.D. at least once a year.  Make an appointment promptly if you experience blurred vision and/or floaters that:

• Affect only one eye
• Last more than a few days
• Are not associated with a change in blood sugar
  

In advanced cases of diabetic retinopathy, laser treatment has been shown to reduce the chance of severe vision loss and blindness.  This surgery does not cure diabetic retinopathy or restore vision that has already been lost, nor does it prevent future vision loss, especially if diabetes or blood pressure is not well controlled.

Diabetes can also affect your vision by causing cataracts and glaucoma.  If you have diabetes, you may get cataracts at a younger age and your chances of developing glaucoma are doubled. Early diagnosis of diabetes and most importantly, maintaining strict control of blood sugar and hypertension through diet, exercise and medication can help to reduce your risk of developing eye diseases associated with diabetes.

An Eye M.D. is an ophthalmologist - a medical doctor who provides the full spectrum of eye and vision care. From eyeglasses and contact lenses to medication and surgery, your Eye M.D. will help you keep your sight for life.

Copyright © 2005 American Academy of Ophthalmology®

Health Information from the National Eye Institute:
Diabetic Retinopathy Resource Guide
Diabetic Eye Disease:  How Much Do You Know?  Take this Quiz and Find Out
Diabetic Eye Disease:  A Self-Guided Module

Information for Referring Physicians:

Diagnosis of Diabetic Eye Disease JAMA 247:3231-3234, 1982
Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies Diabetes Care 26:2653-2664, 2003

2007 Physician Quality Reporting Initiatives

Measure #18: Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

The American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE), American Diabetes Association (ADA), and American Academy of Ophthalmology (AAO) recommend that a dilated eye examination be performed on patients with diabetes during an initial assessment and at least annually thereafter.

The AACE/ACE and AAO recommend that diabetic patients should be under the care of an ophthalmologist experienced in the management of diabetic retinopathy. Ophthalmologists with specialized knowledge and experience in managing the disease are best able to detect and treat serious disease.

Measure #19: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Ophthalmologists and optometrists should provide a report back to the provider after each eye exam or funduscopic imaging. The eye report should include the level of diabetic retinopathy, the next recommended follow-up evaluation, and the specific medical eye management plan.

Photographs Courtesy of National Eye Institute, National Institutes of Health