Unfortunately, diabetes is reaching epidemic proportions in the United States. The eye is the only structure in the body that allows us to directly visualize microvascular changes. Because of this, we are able to detect the presence of systemic diabetes if diabetic retinopathy is present.
Diabetes causes damage to the basement membrane in vessels which leads to them becoming leaky and compromising the blood-retinal barrier. Leakage of blood and fluid into the retina can lead to vision loss, hypoxia (lack or oxygen), and eventually the formation of neovascularization (new blood vessel formation).
The onset of diabetic retinopathy in a diabetic is not a question of if, but when. 80% of diabetics will develop retinopathy after 10 years of having the disease. There is a wide range of severity in the condition, and only two findings that necessitate treatment. Macular edema and neovascularization are both indications for the need for retinal laser treatment. If these are not present, most diabetics can be monitored on a yearly basis with a dilated eye exam and retinal photos.