Diabetic eye disease: a primary care perspective

Patients with diabetes are at risk for multiple visual complications, most notably diabetic retinopathy, but also glaucoma, cataracts, optic nerve disease, and strabismus. Diabetic retinopathy is the leading cause of blindness for the majority of Americans. Microvascular damage from diabetes leads to microaneurysms, hemorrhage, exudates, and cotton-wool spots. Further progression of disease leads to new vessel growth, or neovascularization. Growth of new blood vessels can cause severe hemorrhage, scarring, and permanent visual loss. Various randomized, prospective studies have clearly shown benefit from laser therapy at specific stages of progression of retinopathy. Proper referral and close follow-up are paramount to the preservation of visual function.