Diabetic retinopathy: a growing concern in an aging population.

Diabetic retinopathy--already the leading cause of irreversible blindness in working age Americans--is a rising threat as the diabetic population increases. Vision loss occurs due to retinal ischemia, retinal vascular exudation, intraocular hemorrhage, and ultimately, fibrotic complications. Optimal management of blood glucose levels and hypertension reduces the incidence and progression of retinopathy. Appropriate screening ensures early detection and management of diabetic retinopathy and reduces vision loss. Recent advances in our understanding of diabetic microvascular complications have led to new treatments that, along with refinements in laser and surgical techniques, are improving visual outcomes.