[Diabetic retinopathy--screening is a requirement. Don't wait until vision becomes impaired]

Diabetic retinopathy is the most common systemic disease capable of leading to blindness. Laser treatment of diabetic retinopathy is standardized; in most cases it can prevent blindness, provided the diagnosis is made in good time. Since impairment of vision is a late complication, systemic screening examinations are of particular importance if we are to reliably determine the optimal time for treatment. Advances in vitreoretinal surgery make possible the treatment of such late manifestations as vitreous hemorrhage and tractive retinal detachment. Provided that stage-oriented and timely treatment is forthcoming, these formerly hopeless cases should become a rare exception. The currently sole confirmed medical treatment is optimal control of blood sugar--based on the HBA1c value--and of blood pressure. The clinical efficacy of inhibitors of angiotensin converting enzyme or protein kinase C is presently undergoing investigation.