Diabetic retinopathy is damage to the eye that results from chronically untreated or inadequately treated high blood sugar. In its more advanced form, it can result in severe visual loss or blindness if untreated, and this can occur suddenly without warning. It is the leading cause of blindness in working age adults in the United States and more than 20,000 people become blind as a result of diabetes each year.
In order to pre-vent this, all people with diabetes should periodically be screened with an eye exam or photography of the inner lining of the eye (retina). Because it is often not possible to pinpoint precisely when type 2 diabetes actually develops, as it may be silent and unrecognized for months or even years, people with type 2 diabetes should be examined for retinopathy at the time of diagnosis, while those with type 1 diabetes should be examined between 3 and 5 years after the diagnosis has been made. The frequency with which follow-up visits is recommended will depend upon the findings and the measures taken to address them. For example, if no retinopathy is detected, follow-up examination in 2 years may be recommended, whereas in the case of serious findings requiring active treatment, follow-up in 3 months or fewer may be required.
Although it has clearly been shown that the rate of progression of diabetic retinopathy is related to the control of the blood sugar, there are several other factors involved. There is a hereditary tendency, so that if a close relative with diabetes developed retinopathy, you are more likely to do so. You should inform your eye doctor, who will be especially vigilant. Control of blood pressure has been shown to delay worsening of retinopathy and control of cholesterol abnormalities also plays a role in preventing progression. Quitting smoking can slow the progression of diabetic retinopathy.
Therefore, all of these factors must be carefully addressed to prevent retinopathy successfully. Finally, it is important to note that retinopathy is not the only form of eye damage that can occur in diabetes. Other disorders, including glaucoma (increased pressure inside the eye) and cataracts (opacity of the lens of the eye), are more common in diabetes. Therefore, a comprehensive specialist eye exam is periodically needed and retinal photographs alone are not adequate.