Diabetic retinopathy is a leading cause of preventable vision impairment and blindness in the US/World. It occurs in about a third of people with diabetes and its damaging effects on vision can be prevented by early detection and treatment through screening. Vision impairment and blindness have major economic consequences in terms of use of health and social care resources and impact on economic productivity (WHO, 2019). Diabetic retinopathy mainly is caused by the effect of raised blood glucose on the blood vessels in the retina. It can be prevented, and its progression slowed, by control of blood glucose, blood pressure and elevated lipids. If it progresses to an advanced form, treatment with laser and, if available, intraocular drug injections can prevent vision impairment and blindness. Diabetic retinopathy screening can identify early changes in the retina so treatment can be given before vision impairment or blindness occurs.

Although Center for Medicare and Medicaid Services (CMS) offers incentives to insurance companies to meet screening targets under HEDIS program and most insurance companies have some form of eye checks campaign in place for people with diabetes, these campaigns are often not adequately resourced or organized systematically as a screening pathway. For that reason, many people with diabetes are living with preventable vision impairment and blindness.