Lowering the risk of visual impairment and blindness

Abstract

Diabetic retinopathy remains the leading cause of visual disability and blindness among professionally active adults in economically developed societies, which is of particular concern because the prevalence and incidence of Type 2 diabetes mellitus is expected to increase sharply during the next decade. Retinopathy is fundamentally similar in Type 1 and Type 2 diabetes mellitus, and it is widely accepted that if detected and treated early, loss of vision and blindness from diabetic retinopathy may be prevented. Studies such as the Diabetes Control and Complications Trial (DCCT), the United Kingdom Prospective Diabetes Study Group (UKPDS), the Diabetic Retinopathy Study (DRS) and the Early Treatment Diabetic Retinopathy Study (ETDRS) have established accepted guidelines for the management of diabetic retinopathy. Good metabolic control is particularly important in the early phases of the disease, and will delay the onset of retinopathy and decrease the rate of progression. When advanced stages of retinopathy are reached, laser photocoagulation is effective in decreasing the development to blindness by over 50%. However, preventable blindness still occurs despite the tight control of blood glucose levels and the use of retinal photocoagulation. To reduce the risk of visual impairment and blindness caused by diabetes, diabetic patients must be taught how to control their blood glucose levels, regular eye examinations must be carried out and the conditions for timely laser photocoagulation must be created. The implementation of screening and treatment programmes for visual impairment in diabetes has proved to be worthwhile in terms of costs and health benefits.