Loss of sight is one of the biggest concerns for everyone with diabetes, with lower income groups having bigger fears than others. These feelings exist despite solid data that the risk of vision loss is low and decreasing. For example, diabetes is no longer the leading cause of vision loss in working age adults. I think that part of this confusion comes from imprecision when discussing retinopathy. Today’s paper simplifies the categorization into 4 classes of retinopathy: none, background, preproliferative, and proliferative. They also add in a class including the presence or absence of maculopathy. This is important as macular edema is now the leading cause of vision loss in type 2 diabetes. While retinopathy is common in people with diabetes, proliferative retinopathy is much less common. Regular eye exams by an experienced eye professional are the most important factor behind this decrease, along with control of A1C, blood pressure and LDL cholesterol.

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