Diabetic retinopathy: An overview for non-ophthalmologists

Nearly all patients with type 1 diabetes, and most with type 2 diabetes, eventually develop diabetic eye diseases, including diabetic retinopathy. Even in the advanced stages, diabetic retinopathy can be asymptomatic; yet it is the leading cause of new cases of blindness among working-age US adults. This article describes various ocular signs of diabetic retinopathy, such as microaneurysms, hard exudates, intraretinal hemorrhages, and cotton wool spots, all of which are visible on direct ophthalmoscopy and should trigger prompt consultation with an ophthalmologist. Referral of patients with diabetes to ophthalmologists for regular dilated eye examinations also is vital, as timely treatment can preserve vision in many patients. Additional ways in which physicians can help control or prevent progression of diabetic retinopathy include strict control of blood glucose, body weight, cholesterol, and blood pressure. A team approach to prevention and diagnosis gives patients with diabetes the best opportunity to preserve their vision.