In Reply We appreciate the comments by Feng and Sivakumaran regarding our article evaluating the functional burden of diabetic retinopathy (DR) across severity levels in the United States. Indeed, we agree with the concerns that were raised, although we addressed many of them in our article. We would like to use this opportunity to clarify the study limitations while elaborating on the strengths of the National Health and Nutrition Examination Survey (NHANES) and the need for an updated national ophthalmic survey in the United States.