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Purpose: Regular screening for both diabetes mellitus and diabetic eye disease should be the gold standard in preventing diabetic blindness. In the community of Laxa, County of Orebro, Sweden, such screening has been carried out since 1983. We evaluate visual impairment and blindness in this population.

Methods: All persons in the community of Laxa with a diagnosis of type 2 diabetes mellitus (n = 276) participated in the study. An age- and gender-matched control group (n = 259) was assembled. Best corrected visual acuity (BCVA) was tested in all participants, and a detailed eye examination performed by an ophthalmologist.

Results: No significant statistical differences were seen between the diabetes and control groups regarding visual acuity (VA). In all, 2.9% of the diabetes patients and 1.2% of the controls had BCVA <= 0.1. Only one person in the diabetes group was blind as a result of diabetic retinopathy. In both groups the leading cause of blindness was age-related macular degeneration. In a logistic regression analysis we found that in both the diabetes and the control populations, increasing age was related to worsening BCVA (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.10-1.16 versus OR 1.16, 95% CI 1.13-1.19), as was female gender in the diabetes group only (OR 2.73, 95% CI 1.69-4.40).

Conclusions: In a population that is carefully screened for diabetes mellitus and provided with regular screening for diabetic retinopathy, the loss of vision from diabetic retinopathy is uncommon.

Copyright (C) 2007 Blackwell Publishing Ltd.