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Diabetes Can Steal Vision Before Symptoms Appear
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During Diabetes Awareness Month, Dr. Robert Foster urged adults—especially those with diabetes or prediabetes—to treat eye exams and lifestyle changes as urgent preventive care.
Diabetes can damage a person’s eyesight long before a loss of vision forces an appointment. That was the central warning from Dr. Robert Foster of Legacy Eye Care, who described diabetic retinopathy as a major, preventable threat to sight and a growing health burden in North Carolina.
The message carries particular weight in Black communities, where Foster said diabetic retinopathy affects African Americans at a higher rate than the groups he cited. His argument was direct: medication and advanced treatments may help manage damage, but protecting vision starts earlier—with knowing key health numbers, getting dilated eye exams and making sustainable lifestyle changes.
A Silent Threat to Vision
Foster described diabetes as the leading cause of preventable blindness in the United States and said diabetic retinopathy occurs when the disease affects the inside of the eye. Unlike an obvious injury, the condition can progress without immediately changing how clearly someone sees. That makes the absence of symptoms a poor measure of eye health.
A dilated eye examination is the practical front line of detection. Foster explained that special drops widen the pupil so an eye doctor can inspect the eye’s interior and observe blood vessels. He called the eye one of the only places in the body where clinicians can directly see vascular changes at work, potentially identifying signs of diabetes and related disease before more serious complications take hold.
North Carolina Faces a Heavy Diabetes Burden
The scale Foster outlined is sobering. He said more than 1 million people in North Carolina have diabetic retinopathy, while 244,000 people have diabetes without knowing it. He also cited a state prediabetes rate of roughly 34 percent, evidence that the challenge is not limited to people who have already received a diagnosis.
The economic cost is substantial as well. Foster cited a $2.9 billion North Carolina expense tied to diabetes treatment and people unable to work, noting that figure came from 2017 and may have grown. Behind those numbers are families managing doctor visits, medication, vision risks and the wider consequences of chronic illness—costs that can affect work, caregiving and long-term community stability.
Why Prevention Cannot Wait Until Vision Changes
Foster pushed back on a common assumption: seeing clearly does not mean a person’s eyes are healthy. He recommended that everyone receive an eye examination at age 40, even if their vision seems fine, and said younger people with persistent headaches should also consider an eye evaluation. In his view, routine care is not merely about whether someone needs glasses; it is an opportunity to look for problems inside the eye.
For people with diabetes, the urgency rises when blood sugar is uncontrolled. Foster said an A1C above 7 increases the likelihood of diabetic retinopathy at any age, and he voiced special concern for people with Type 1 diabetes. Treatments including injections, laser procedures, medication and vitamins can be used once damage is identified, but he emphasized that they are not substitutes for addressing the conditions driving the disease.
Lifestyle Changes Are the Long Game
Foster’s core prescription was lifestyle change. He encouraged listeners to know their A1C, blood pressure and cholesterol numbers, find a way to exercise and stop smoking. He framed diabetes as a lifestyle disease and argued that even useful medications can become a false sense of security if patients treat a prescription as permission to avoid broader changes.
Food choices were a major part of that conversation, especially with holiday meals approaching. Foster said people whose lifestyles are more sedentary cannot necessarily eat the way earlier generations did while doing physically demanding work. He suggested adapting familiar meals, including choosing turkey rather than pork in collard greens, and advised diabetics and prediabetics to limit processed foods and high-sugar choices while favoring green leafy vegetables, lean meats, nuts and berries.
What It Means
The most important takeaway is not fear; it is action before a crisis. A person can have diabetes, prediabetes or retinal damage without realizing it, and waiting for blurry vision may mean waiting too long. A dilated eye exam, along with honest attention to blood sugar and other health measures, gives people a chance to confront the risk while prevention is still possible.
Foster connected that prevention to something larger than a medical checklist: being healthy enough to remain present for children, grandchildren and the wider community. Diabetes Awareness Month is a timely reminder that protecting vision is not only about the eyes. It is about making informed decisions now that preserve independence, family connection and quality of life later.
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