There are many health risks associated with diabetes, but the disease can especially impact vision. Diabetes is the leading cause of new blindness cases among adults age 20 to 74 years. Diabetic eye disease causes 12,000 to 24,000 more people to go blind each year, according to the National Institute of Diabetes, Digestive and Kidney Statistics. Studies have shown people with diabetes face a risk for blindness that is 25 times greater than non-diabetics. Smoking diabetics, poorly managed diabetics and nutritionally challenged ones have an even greater risk. Diabetic retinopathy is a common diabetic complication. Elevated blood sugar levels damage the retinal blood vessels, causing them to break down, leak, or become blocked. Over time, this causes retinal bleeding. When oxygenated blood can’t easily reach the retina, abnormal new blood vessels can grow. These new vessels are fragile and can break easily, causing permanent vision loss. The Diabetic Control and Complications Trial Research Group reports 1 in 12 people with diabetes age 40 years and older has vision-threatening diabetic retinopathy. People with diabetes can maintain healthy eyes by having an annual comprehensive vision examination which includes dilation. The scientific journal Ophthalmology has stated early detection and treatment can prevent or delay blindness caused by diabetic retinopathy in 90 percent of diabetics. Good blood sugar control has been shown to reduce retinopathy  development by 76 percent. Moreover, intensive insulin therapy reduces the first appearance of the eye disease by 27 percent. Even the worst form of the disease, proliferative diabetic retinopathy, can be combated with laser surgery. For patients who have experienced uncorrectable vision loss due to diabetes, optometrists and ophthalmologists can help by providing low-vision aids ranging from simple hand magnifiers to innovative optical devices.  They can also access a full spectrum of care and services, allowing people with diabetes-related vision impairment to maintain their independence and regain the ability to read instructions, take medication, or complete household tasks. If you have diabetes or have a family history/risk factors, remember that people with diabetes should have an exam by an eye specialist (optometrist or ophthalmologist). These are the only professionals with the level of expertise or complex diagnostic equipment needed by the diabetic patient. Remember:

• Most people with diabetes should have a dilated eye examination by an optometrist or an ophthalmologist annually.
• According to the American Diabetes Association, if a person with diabetes has had a normal result for his or her eye exam, an eye care provider may suggest less frequent exams, perhaps every 2–3 years.
• Examinations will be needed more frequently if retinopathy exists tor is progressing.

Cynthia Heard, O.D., FAAO. - Cynthia Heard, O.D., FAAO.,  graduate of Ohio State University College of Optometry, serves as an Associate Professor at Southern College of Optometry. A former president of the National Optometric Association, her professional areas of interest include diabetes patient education and nutrition and eye health.