A new study reveals a troubling trend: nearly 10 million Americans are now living with diabetic retinopathy, a complication of diabetes that can cause vision loss or even blindness.
Among them, almost 2 million have the most serious form, known as vision-threatening diabetic retinopathy (VTDR). These numbers reflect the growing burden of diabetes in the U.S. and highlight the urgent need for better screening and care.
The study, published online June 15 in JAMA Ophthalmology, used data from the CDC’s Vision and Eye Health Surveillance System. Researchers found that as of 2021:
- 9.6 million people with diabetes (or 26%) had diabetic retinopathy.
- 1.8 million had VTDR (about 5% of all people with diabetes).
- Among adults aged 40 and older, about 1 in 4 have some form of diabetes-related eye disease—more than twice the rate seen in 2004.
“These findings show how diabetes can affect eye health on a massive scale,” said David Rein, senior author and public health expert at NORC at the University of Chicago. “It’s mainly driven by the sharp rise in diabetes over the past two decades, and it tells us that diabetic eye care needs to be a top priority.”
What Is Diabetic Retinopathy?
Diabetic retinopathy happens when high blood sugar damages the small blood vessels in the retina—the part of the eye that senses light. As Dr. Talia Kaden, an ophthalmologist in New York, explains, this damage can cause swelling, bleeding, or the growth of abnormal new vessels in the eye. If untreated, these changes can lead to serious vision loss or blindness.
The condition tends to get worse over time, especially if blood sugar is not well controlled. However, early diagnosis and treatment can protect vision—sometimes even restore it.
Young Adults and Minority Groups Disproportionately Affected
The study also uncovered important differences by age and race:
- Among people under 25, more than 1 in 10 with diabetes already have signs of diabetic retinopathy.
- In those aged 25 to 39, nearly 1 in 5 are affected.
- Black Americans (9%) and Hispanic Americans (7%) are more likely to have VTDR than White Americans (4%).
“This points to deeper issues like poverty, lack of access to health care, and poor diet,” said Rein. “These social factors are making it harder for some communities to manage diabetes and avoid complications.”
Geographic Differences
The rates of diabetic eye disease also vary widely by state, ranging from 21% in Nevada to 34% in Hawaii. The highest rates were found in some of the nation’s poorest regions, especially in the Deep South, where diabetes is more common and harder to manage.
Interestingly, the prevalence of diabetic retinopathy increases with age, but then drops in the oldest age groups. Researchers say this is likely because people with severe diabetes—and thus a higher risk of eye complications—may not live as long.
Why Screening Matters
One of the biggest takeaways from the study is that early detection can make all the difference. Both Rein and Kaden stressed that every person with diabetes should have an eye exam at least once a year. If any signs of damage are found, visits may need to be more frequent—even monthly.
“If there’s swelling or bleeding, we can treat it with injections, medications, or laser therapy,” said Dr. Kaden. “But we have to catch it early.”
Dr. Xiangrong Kong, from Johns Hopkins University, wrote an editorial alongside the study urging health professionals and policymakers to act. “Preventing vision loss should be a key part of diabetes care,” she said. “This is something we can address—if we don’t ignore it.”
Review and Analysis
This study is a wake-up call about the hidden threat of diabetic retinopathy. With diabetes numbers continuing to rise—affecting tens of millions of Americans—the eye complications that come with it are becoming more common too. Yet, the good news is that vision loss from diabetes is largely preventable with routine screenings and timely treatment.
What makes this issue urgent is that many people—especially younger adults, underserved communities, and those living in poverty—may not have regular access to eye care. The healthcare system, especially programs like Medicare, Medicaid, and the CDC, must ensure that screening and treatment are widely available, particularly in high-risk areas.
In the meantime, the message to patients is clear: If you have diabetes, get your eyes checked every year. It’s one of the easiest ways to protect your vision for the future.
If you care about diabetes, please read studies that MIND diet may reduce risk of vision loss disease, and Vitamin D could benefit people with diabetic neuropathic pain.
For more information about diabetes, please see recent studies that Vitamin E could help reduce blood sugar and insulin resistance in diabetes, and results showing eating eggs in a healthy diet may reduce risks of diabetes, high blood pressure.
The research findings can be found in JAMA Ophthalmology.
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