Diabetic retinopathy: treating systemic conditions aggressively can save sight.

To control diabetic retinopathy, we need not only to detect it promptly, but also to manage common systemic comorbid conditions such as hypertension, hyperlipidemia, anemia, obstructive sleep apnea, and smoking--all of which tend to accelerate its course and increase its severity.

The internist's role in managing diabetic retinopathy: screening for early detection.

Although laser treatment keeps vision damaged by diabetic retinopathy from becoming worse, it only rarely improves vision. If primary care physicians wait until the patient complains of blurred vision, it is too late--there is already permanent retinal injury, and the lost vision almost never can be restored. Unfortunately, only half of patients with diabetes undergo an appropriate examination every year.