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Millions risk blindness from diabetic retinopathy About 16 million Americans have diabetes and half are at risk for vision loss because they do not know they have the disease. “This is a tragedy waiting to happen because people with diabetes can develop a complication called diabetic retinopathy, which blinds over 8,000 Americans each year,” said Arman Farr, M.D., a retina specialist at MUSC Storm Eye institute. “But vision loss from diabetic retinopathy can be prevented if it's caught and treated in time.” A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.  So, as part of Diabetic Eye Disease Awareness Month ophthalmologists across the country are urging Americans with diabetes to have a dilated eye exam every year.  The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease. For some people, diabetic retinopathy—a degenerative disease of the retina (the sensitive area at the back of the eye)—is one of the first signs that they have diabetes. High blood sugar levels can weaken blood vessels in the eye's retina causing them to leak blood or fluid. This causes the retina to swell and form deposits that can lead to vision loss. Blood sugar fluctuations can also promote growth of new, fragile blood vessels on the retina, which can break easily and leak blood into the vitreous (the  clear, jelly-like substance that fills the center of the eye.) This can also blur vision and lead to permanent vision impairment. What are the signs to look for?  “At first there may be no symptoms as the disease progresses. Also because fluctuations in blood sugar levels can temporarily affect vision, it's sometimes hard to know if a serious eye problem is developing,” said Farr. “That's one of the reasons good glycemic control is so important. If you notice a vision change in one eye, a change that lasts more than a day or two or a change not associated with fluctuations in blood sugar call your eye doctor.” Of course, the first step in preventing all complications of diabetes is knowing if you have the disease. Eight million Americans have diabetes, but do not know it and therefore, may be at risk for blindness. It's important for all healthy adults over the age of 45 to have a blood sugar test once every three years to be screened for diabetes.  “If you're diagnosed with diabetes, schedule eye exams once a year or as often as your eye doctor suggests,” said Carolyn Cavanaugh, R.N., “and monitor your blood sugar and keep it under control through diet and exercise. The mission of MUSC Storm Eye Institute is to promote eye health in the community, and to help prevent blindness from diabetic retinopathy. A free diabetic retinopathy screening will be held on Nov. 22. To make an appointment for the screening, call Health Connection at 792-1414. For more information, or to receive a free diabetic retinopathy brochure, call  Cavanaugh at 792-4735. Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.