According to a 2018 American Eye-Q Survey conducted by the American Optometric Association (AOA), nearly half of Americans didn't know whether diabetic eye diseases have visible symptoms.1 The same survey found that more than one-third of Americans didn't know a comprehensive eye exam is the only way to determine if a person's diabetes will cause blindness.
The World Health Organization2 says the number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014; 2.6% of global blindness can be attributed to diabetes. The group also advocates screening and treatment for retinopathy as a cost saving intervention. In Global Report on Diabetes,3 the WHO said type 1 diabetes is the result of complex interaction between genes and environmental factors, while the risk for type 2 diabetes is determined by an interplay of genetic and metabolic factors.
Specifically, the report noted ethnicity, family history of diabetes, and previous gestational diabetes combined with older age, weight, unhealthy diet, physical inactivity, and smoking increases the risk. The AOA notes that specific risk factors for type 1 diabetes are unclear, but family history, viral exposure (e.g., Epstein-Barr virus), or autoimmune disorders may play a role.4
1. Diabetic Retinopathy. Available at: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary... Accessed October 15, 2019. St. Louis, MO: American Optometric Association, 2019.
2. World Health Organization. Diabetes Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed October 26, 2019. Geneva, Switzerland: WHO, 2019.
3. World Health Organization. Global Report on Diabetes. Geneva, Switzerland: WHO, 2016.
4. American Optometric Association. Eye Care of the Patient with Diabetes Mellitus: Evidence-Based Clinical Practice Guideline. Optometric Clinical Practice Guideline. Available from: http://www.aoa.org/Documents/EBO/EyeCareOfThePatientWithDiabetesMellitus.... Accessed October 15, 2019. St. Louis, MO: American Optometric Association, 2014.
5. Prevent Blindness America. Vision Problems in the U.S. Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America. Accessed June 20, 2012. Chicago, IL: Prevent Blindness, 2012.
6. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care 1992;15(7):815-9.
7. Kohner EM, Aldington SJ, Stratton IM, et al. United Kingdom Prospective Diabetes Study, 30: diabetic retinopathy at diagnosis of non-insulin-dependent diabetes mellitus and associated risk factors. Arch Ophthalmol 1998;116(3):297-303.
8. American Diabetes Association. Executive summary: Standards of medical care in diabetes--2013. Diabetes Care 2013;36 Suppl 1:S4-10.
9. American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern Guidelines: Diabetic Retinopathy. San Francisco, CA: 2016.
10. Yung CW, Boyer MM, Marrero DG, Gavin TC. Patterns of diabetic eye care by primary care physicians in the state of Indiana. Ophthalmic Epidemiol 1995;2(2):85-91.
11. Ozerov I, Monderer R. Diabetic retinopathy: Examination and referral practices of primary care providers. Einstein Quart J Biol Med 2001;18:164-70.