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Diabetic retinopathy is an eye disease caused by complications from diabetes. It is the most common diabetic eye disease and a leading cause of blindness in American adults. Some people experience changes in the blood vessels of the retina where the vessels swell and leak fluid, while others may experience growth of abnormal blood vessels on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye and is necessary for good vision.

All people with diabetes, both type 1 and type 2, are at risk for diabetic retinopathy. Approximately 40-45% of Americans diagnosed with diabetes have diabetic retinopathy and are at some stage in its progression. Yearly comprehensive dilated eye exams are necessary for those with diabetes to prevent a rapid progression of vision loss.

Symptoms of diabetic retinopathy are varied and there are four identified stages. In the early stages, there often are no symptoms and no pain. Later stages may bring swelling to the macula from leaking fluid or blood vessels growing on the surface of the retina which can bleed into the eye and cause vision loss. Diabetic retinopathy usually affects both eyes. Comprehensive eye exams are necessary to diagnose diabetic retinopathy, identify stages and prevent vision loss.

Early stages do not require treatment, but controlling blood sugar levels, blood pressure and cholesterol are helpful in preventing the progression of diabetic retinopathy. Proliferative retinopathy, the most advanced stage, requires treatment using laser surgery. There are other more invasive surgical treatments, if necessary.

Practical Implications

In advanced stages of diabetic retinopathy blind spots and blurry vision can occur. A person with diabetic retinopathy may have daily changes in vision depending on the amount and extent of blood leakage and the resulting damage. This may cause extreme anxiety and fear due to the unstable nature of the progression. As a result, planning for accommodations can be challenging as there may be daily changes in vision. It is a good strategy to take time to discuss with the consumer their current visual condition before engaging in any in-depth conversations or intense visual tasks to ensure that the accommodations meet the person’s needs at that time.