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Like a camera out of focus, Maria Garcia's eyes still register what is most important -- the faces of her children and grandchildren -- though they are gently eroding, replaced by hazy silhouettes.
The 51-year-old San Jose resident is slowly losing her vision.
Despite this, Garcia counts herself lucky. Without treatment and early detection of her diabetes, the fuzzy images that can be fixed for now with glasses could have become permanent blindness, a common complication of the disease.
Garcia's plight is echoed in a recent study by the University of Southern California's Keck School of Medicine.
Results from the Los Angeles Latino Eye Study, published this summer in the journal Ophthalmology, show high rates of eye diseases such as diabetic retinopathy and open-angle glaucoma among 6,357 Latinos age 40 or older.
The people in the study are primarily of Mexican descent and live in the city of La Puente.
Researchers say the five-year study, funded by the National Institutes of Health, is the largest of its kind and may indicate a greater need for eye-care outreach to the Latino community.
"Because Latinos have high rates of eye disease, they should get regular eye exams at least once a year, especially if they are age 50 or older," said study director Dr. Rohit Varma, an associate professor of ophthalmology and preventive medicine.
Researchers screened participants for eye disease and diabetes and interviewed them to assess risk factors and quality of life.
Overall rates of vision problems among U.S. Latinos are high, and older Latinos have the highest rates of visual impairment among all other racial or ethnic groups in the country, said Varma.
He said a genetic predisposition to eye disease and a lack of sufficient eye care among many Latinos may account for the disparity.
"Right now, I think that both of these issues probably play a role, but we don't know for sure," he said.
Higher rates of diabetic retinopathy, a complication of diabetes, in the Latino population are closely tied to high rates of diabetes.
According to the American Diabetes Association, 2 million U.S. Latinos age 20 or older have diabetes. The prevalence of type 2 diabetes is 1.5 times higher in Latinos than non-Latino whites.
Los Angeles researchers noted almost one in four participants had diabetes, and 20 percent of them were not aware of their condition until the study.
Of those with diabetes, nearly half also had some signs of diabetic retinopathy, and many did not know they had an eye disease.
Garcia, who was diagnosed with diabetes five years ago, said her doctor never used the term "diabetic retinopathy," to refer to her condition but did say her vision problems stem from diabetes and high blood pressure.
Before she was diagnosed with diabetes, her vision was normal. Now she must wear glasses, and her prescription continues to get stronger every year, said her daughter Lupe Arango, 22, who works with the Community Health Partnership, a coalition of community clinics in Santa Clara County.
The Los Angeles study found 4.74 percent of participants had open-angle glaucoma, a disease that puts pressure on the eye's optic nerves. According to data from the National Eye Institute, the overall rate for people in the United States age 40 and older is about 1.86 percent.
"The numbers are illuminating," showing that many Latinos have undiagnosed eye disease, said Dr. Dipali Apte, a regional glaucoma consultant for Kaiser-Santa Clara hospital.
Given that the Latino population is expected to grow to almost 25 percent by the year 2050, Apte said she expects the study will prompt some changes in standardized care.
Lack of routine eye care among Latinos is one complicating factor with glaucoma, Varma said. Among participants, 35 percent said they were uninsured.
There is no cure for glaucoma, but it can be controlled with medication and surgery. If left untreated, however, it can lead to blindness.
For Garcia, the threat of going blind motivates her to keep her diabetes in control by watching what she eats and monitoring her blood sugar.
Garcia, who immigrated from Michoacan, Mexico, 25 years ago, recently lost her job and, with it, her health insurance.
Garcia, whose grandmother lost her vision to diabetes shortly before she died, fears more than anything being a burden to her children, who range in age from 22 to 32.
"Vision is the soul of everything," she said.
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