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Leese G. P., Ellis J. D.
The prevalence of diabetes is increasing dramatically, being 3-8% in Western society. The prevalence is closely related to obesity and ethnicity, but is predicted to double every 8-10 years. A number of risk factors have been identified for diabetic retinopathy, but there is only evidence that improving glycaemic and blood pressure control improves outcomes. Screening is important as diabetic retinopathy is asymptomatic at the stages when treatment is most effective. The relative merits of different screening tools, such as ophthalmoscopes, slit lamps, and retinal cameras, are discussed. For retinal photography, issues surrounding the use of eye drops, multiple field photography, and digital image compression are described. Recent data on screening intervals are presented, with the possibility of two-yearly screening for some patients. Laser treatment is well validated, but possible new treatments such as ocular steroids and protein-kinase C inhibitors are described. Thus, although many advances have been made in the management of diabetic eye disease, there are still many exciting new developments, which should not only help prevent blindness, but also improve visual outcomes and reduce partial sightedness.