Alicia Lombardo was 8 years old when her optometrist made a big impression on her, fitting her with glasses that improved her vision. She decided that she wanted to help others in the way shed been helped, and she graduated from the Pennsylvania College of Optometry in Philadelphia in 1997. This October, she celebrates 10 years of working with Sams Club.

Q. What risks does diabetes pose for people’s vision?

A.In a healthy person, the pancreas secretes insulin to pull extra sugar out of the bloodstream and eliminate it from the body. In diabetics, the pancreas does not function properly, and too much sugar remains in the bloodstream. This causes the blood to become thicker than normal.

As this thick blood courses through the smaller blood vessels, it damages them, causing them to leak. The smallest blood vessels, such as those in the lining of the eye, are more susceptible to this damage. When the vessels leak, the tissue in these areas does not get enough blood. This causes permanent damage and can lead to an increased risk of cataracts, glaucoma and retinal detachments. Most notably, it often leads to diabetic retinopathy.

Q. What is diabetic retinopathy?

A.In diabetic retinopathy, damage from diabetes occurs in the lining of the eye, known as the retina. The blood vessels in the retina hemorrhage so much that the condition can cause permanent vision loss. Diabetic retinopathy is the leading cause of irreversible blindness in adults ages 20 to 74.

The longer a person has diabetes, the greater the risk. Studies show that people who have had diabetes for at least 10 years have a 50 percent chance of developing diabetes-related changes to their eyes.

About 65,000 diabetics develop retinopathy each year, but with proper treatment and monitoring, 90 percent of these new cases can reduce their risk of permanent vision loss.

Q. How can an exam by an optometrist help prevent or minimize diabetes-related vision loss?

A.Routine eye examinations, including a dilated retinal evaluation, can help screen for diabetic changes in the eyes. An optometrist can evaluate the retina and, many times, pick up subtle changes that indicate diabetes even before a primary medical care provider can.

The American Diabetes Association suggests that Type 1 and Type 2 diabetics should have a dilated eye exam shortly after diagnosis and follow-up with continued annual eye examinations