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Currently diabetes is the leading cause of blindness among adult persons in the United States. Diabetes affects the vision by damaging the microvascular system (small arteries and veins) in the retina. Increased blood glucose can cause smaller arteries to weaken, form microaneurysms, and leak. This process causes a decrease in the efficiency of the blood movement to all of the areas of the retina, and sometimes the retina will start to grow new blood vessels. The new blood vessels do not typically grow properly and often cause larger problems, like retinal detachments. For this reason, they must be treated immediately with laser to avoid permanent loss of vision.

According to the American Diabetes Association, people with type 1 diabetes should have a comprehensive retinal examination within 5 years of diagnosis, and then every year after. People with type 2 diabetes should have a comprehensive retinal examination immediately after being diagnosed, and every year after. If a patient is diagnosed with damage to the retinas from diabetes, sometimes more frequent examinations are needed in order to allow for earlier detection of sight-threatening changes.