Diabetic retinopathy: everybody's business

Diabetes increases the risk of a range of eye diseases, including cataract, but the main cause of blindness associated with diabetes is diabetic retinopathy (DR). DR usually develops between ten and twenty years after the onset of diabetes, and develops faster when diabetes is undiagnosed and untreated. People with DR whose sight is at risk can be treated, most commonly with laser, to prevent visual impairment and blindness. Sadly, there is no treatment that can restore vision that has already been lost. In 2030, the number of people with diabetes is expected to increase to 440 million, 54% more than in 2010. This means that, for every two people with diabetes today, there would be three in 2030. But there will be a far greater increase in some of the world’s poorest regions (Table 1, overleaf). In sub-Saharan Africa, for example, the expected increase is 98%, which means the number of people with diabetes there would double. As the prevalence of diabetes increases, so will the risk of DR. In 2002, the global average risk of blindness from DR amongst people with diabetes was calculated as 0.75% – meaning that, out of every 133 people with diabetes, one person will go blind. If we simply apply this statistic to the expected number of people predicted to have diabetes in 2030 (440 million), the number of people likely to go blind from DR would be 3.3 million. In the poorest regions, however, the average risk of blindness from DR tends to be higher than 1 in 133. An important reason for this is that the infrastructure and resources required to effectively address DR are either inadequate or Diabetic retinopathy: everybody’s business Community Eye Health Journal