Preventing blindness in diabetes patients

Published December 6, 2018

There are more than 100 million U.S. adults currently living with diabetes or prediabetes.

People living with diabetes are at increased risk of serious health complications including premature death, heart disease, stroke, kidney failure and amputation of toes, feet or legs. One of the most common complications is diabetic retinopathy, which causes vision impairment and blindness.

From 2010 to 2050, the number of Americans with diabetic retinopathy is expected to nearly double, from 7.7 million to 14.6 million.

Centers for Disease Control and Prevention

To help increase screenings of this condition, Blue Cross and Blue Shield (BCBS) companies across several states are partnering with clinical staff and clinics to help diabetic patients. 

Throughout the upstate New York regions, the Excellus BlueCross BlueShield (Excellus BCBS) Member and Community Health Improvement grant program works with partners to improve access to dilated retinal eye screenings for diabetic patients. These programs allow diabetic patients to be screened on the same day and in the same location as their regular doctor’s appointment. 

By making screening convenient and available in the primary care setting, these programs address such barriers to care as conflicting work schedules, lack of transportation and inadequate access to an ophthalmologist. The goal is for more patients who have diabetic eye disease to be identified early and receive the necessary treatment to prevent blindness.

Retinal images are captured using special camera equipment available right in the primary care office. The images are then transmitted through a secure, encrypted, HIPAA-complaint network and viewed by a board-certified retinal specialist. Images can be used to screen for diabetic retinopathy, cataracts, glaucoma, macular degeneration and other retinal abnormalities that can lead to vision loss and blindness. 

Staff at St. Joseph's Primary Care Center West in Syracuse demonstrate how easy the new dilated retinal eye exam equipment is to use in the primary care setting.


In 2017, Blue Cross and Blue Shield of Illinois launched a pilot program to improve the screening rates of diabetic retinopathy by donating handheld digital cameras to two Federally Qualified Health Centers (FQHCs) in Illinois that serve populations where health and economic disparities are prevalent. 

As part of the pilot, clinical staff at participating FQHCs were trained to conduct the retinal screenings using the digital camera, enabling them to capture images without dilating the pupils with eye drops. The images were then transmitted to eye specialists who delivered a diagnostic report within 90 minutes. 

Nearly 800 screenings were given in the first five months of the pilot program.

About 800 patients received the free exam – and more than 11 percent of them needed to see a specialist for follow-up. 

“In the past, there were a lot of barriers to members with diabetes getting the services they need,” which could put their eyesight at risk, says Esther Morales, a divisional vice president of quality management programs with the Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

Building from this early success, there are plans to broaden diabetic retinopathy screenings in other communities served by BCBS companies in Montana, New Mexico, Oklahoma and Texas.

Excellus BlueCross BlueShield and Blue Cross and Blue Shield of Illinois are independent licensees of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.