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G.M. Zoega, E. Stefánsson, G. Viggósson, I. Gíslason, F. Jonasson; Why Do Some Diabetics Go Blind? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3973.
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Purpose: A systematic nationwide screening program for diabetics has existed in Iceland for more than 20 years. The prevalence of diabetic blindness has been dramatically reduced, but in spite of this some diabetics still lose vision. We study the diabetics who are listed in The National Registry for Blindness (visual acuity: <0.05) and Low Vision (visual acuity: 0.05-0.3) (WHO, ICD-10) and examine the causes of vision loss and participation in the screening program. Methods: 23 diabetics who were alive on November 1, 2002 have blindness or low vision. We examined the demographic characteristics, retinopathy stages, visual acuity, adherence to screening program and preventive treatment and the reason for vision loss. Iceland has approximately 600 type 1 and 4000 type 2 diabetics in a population of 286.000. Results: Two type 1 diabetics are blind and 3 have low vision. Three are male, mean age is 39 years (25-55 years) and the mean duration of diabetes was 28 years (16-48 years). Two type 2 diabetics are blind and 16 have low vision. 14 are female, mean age 75 years (50-85 years) and mean duration of diabetes 17 years (4-40 years). All the type 1 diabetics had vision loss from proliferative retinopathy (PDR), whereas the type 2 patients had either diabetic macular edema (DME) or PDR. Out of the 23 blind and visually impaired diabetics 26% (n=6) had adhered strictly to the screening program. 56% (n=13) already had PDR or DME when they first presented and 34% (n=8) had not had an eye examination in more than one year. Three diabetics lost vision in spite of adhering strictly to the screening program. Conclusions: These results confirm a low prevalence of diabetic blindness and low vision in Iceland. The majority of those who go blind have not participated fully in the public health program and this has probably contributed to their loss of vision.
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