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Diabetes is a significant cause of blindness in many countries of the world today. The incidence of retinopathy which accounts for the major visual impairment is generally proportional to the duration of the disease. Thus, in patients having diabetes for 15 years, approximately 75% show some degree of retinopathy, and after 25 years, approximately 95% have retinopathy. Fortunately, many of these patients with retinopathy maintain useful vision. Although strict diabetic control has been recommended in the prevention of retinopathy, opinion still varies as to its effectiveness. Patients with mild diabetes frequently develop as severe retinal lesions as those with more severe and uncontrollable diabetes. Patients occasionally develop typical retinopathy prior to any demonstrable abnormality in glucose metabolism. This observation suggests that retinopathy may be due to factors other than hyperglycemia.
Friedenwald, Ashton, and others have reported the association of retinal microaneurysms and nodular glomerulosclerosis. The retinal and renal lesions have
Patz A. Diabetic Blindness. Arch Ophthalmol. 1966;75(4):455-456. doi:10.1001/archopht.1966.00970050457001