Diabetes is the leading cause of new cases of blindness in people ages 20-74, according to the American Diabetes Association. Each year, 12,000 to 24,000 people lose their sight because of diabetic eye disease.

Half of all people with diabetes are affected by diabetic retinopathy. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye. Without the retina, the eye cannot communicate with the brain, making vision impossible.

Symptoms
Diabetic retinopathy often has no early warning signs. Eventually, as new blood vessels form at the back of the eye, they can bleed (hemorrhage) and blur vision. As the disease progresses, it enters its advanced, or proliferative, stage. Fragile, new blood vessels grow along the retina and in the clear, gel-like vitreous that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision and destroy the retina.

Detection
It is extremely important that all people with diabetes have an eye examination through dilated pupils at least once a year.

Treatment
There are two treatments that are effective in reducing vision loss from diabetic retinopathy: laser surgery and vitrectomy. In fact, people with advanced retinopathy have a 90 percent chance of keeping their vision if they are treated before the retina is severely damaged. It is important to note that although these treatments are successful, they do not cure diabetic retinopathy.

Check out the National Eye Institute's Web site at www.nei.nih.gov/health/diabetic/retinopathy.htm for more information on the two types of treatments and their continuing research to learn more about the cause of diabetic retinopathy.

A recent study, the Diabetes Control and Complications Trial (DCCT), showed that better control of blood sugar levels slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy. The study found that the group who tried to keep their blood sugar levels as close to normal as possible had much less eye, kidney and nerve disease. This level of blood sugar control may not be best for everyone, including some elderly patients, children under 13 or people with heart disease. Ask your doctor if this program is right for you.