Eye Damage Affects 26% of Those With Diabetes in the US


In 2021, 26% of US residents with diabetes had diabetic retinopathy and 5% had vision-threatening diabetic retinopathy, according to estimates by researchers from the Centers for Disease Control and Prevention and other institutions.


  • Researchers used data from multiple US sources to create composite estimates of the prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy.

  • The data came from population-based studies published after 2000, with prevalence estimates applied to 2021 US census data.

  • Researchers derived county- and state-level estimates.


  • In 2021, the prevalence of diabetic retinopathy was 9.6 million people or 26.4% of US children and adults with diabetes.

  • Prevalence of diabetic retinopathy increased as a function of age before declining in the oldest age groups.

  • Crude diabetic retinopathy prevalence rates by state among those with diabetes ranged from 20.8% in Nevada to 31.3% in Massachusetts.

  • The prevalence of vision-threatening diabetic retinopathy was 1.84 million people or 5.1% of US children and adults with diabetes.


“Preventing vision loss from this diabetes complication requires long-term glycemic control and routine dilated eye examinations to ensure timely diabetic retinopathy detection and treatment,” write the authors.

“The national estimates [in this report] clearly indicate the need for attention by the US and state governments regarding development of national diabetic retinopathy screening programs,” write the editorialists. They add that the estimated prevalence of diabetic retinopathy is 13% in people with diabetes aged 25 years or younger and more than 10% in pediatric age groups. “These numbers call for greater public health awareness of ocular comorbidities in children with diabetes,” they underline.


The study team was led by researchers from the CDC and included researchers from several other US centers. The report has been published online in JAMA Ophthalmology along with an invited commentary.


  • A substantial amount of the data used for the analyses was over 15 years old.

  • Some missing data were imputed.

  • The authors relied on diagnosed diabetic retinopathy and vision-threatening diabetic retinopathy from health insurance claims records, and hence, applied adjustments.

  • Most diabetic retinopathy diagnoses relied on retinal fundus photography, and so the prevalence of vision-threatening diabetic retinopathy may have been underestimated.


The study received no commercial funding. Several authors had personal commercial disclosures. The editorialists have reported no relevant financial relationships.

Mitchel L. Zoler is a reporter for Medscape and MDedge based in the Philadelphia area. @mitchelzoler

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