Brace yourself. There’s a little discussed factoid you need to know if you’ve been diagnosed with diabetes (or prediabetes). The disease is the leading cause of adult blindness in the U.S. Diabetes also ups your risk for cataracts (eye-lens clouding) and glaucoma (optic-nerve-harming eye conditions). Yep, we know. Scary. But there’s a silver lining, says Tacoma, Washington-based Paul Chous, OD, author of Diabetic Eye Disease: Lessons From A Diabetic Eye Doctor. Blindness-causing diabetic retinopathy, which harms blood vessels in the retina (or light-sensitive tissue at back of the eye) is treatable—when spotted early. Case in point? Dr. Chous himself developed diabetic retinopathy at 21. He underwent laser treatment and, 28 years later, his eyesight remains strong.

STEP 1: Get a complete eye exam yearly. Even if your vision seems fine, stresses Dr. Chous. As with all diabetes complications, eye damage can begin sneakily, with no visible warning signs. By dilating the eyes for close retina examination and snapping back-of-eye images, doctors can spot even slight changes (leaking blood vessels, suspect deposits, swelling). A recent American Optometric Association survey found less than half of Americans aware that people with diabetes should have yearly eye exams; 43 percent were unaware diabetic eye diseases strike without symptoms. Seek an optometrist or ophthalmologist with experience treating diabetes.

STEP 2: Recognize signs of diabetes-related eye problems. While even advanced stages of the disease can be asymptomatic, know the visual symptoms that may indicate trouble and alert your eye doctor immediately if any occur: suddenly blurred vision in one or both eyes; eye pain or pressure; double vision (seeing two things where there is one); seeing flashing lights, shadows, rings, or blind spots that have not been there before;  new difficulty focusing.

STEP 3: Keep your glycohemoglobin (also called A1c, or average blood-sugar level) results under 7 percent. This is a quality-of-life number that predicts your odds of developing serious diabetes complications, including vision-threatening eye disease. Research shows that every 10 percent drop in A1c lowers risk of diabetic retinopathy getting worse by more than 40 percent. Ideally, A1c should be less than 6.5 percent, but if you’ve had heart disease and/or diabetes for 20-plus years, set A1c goals with your doctor. Beyond high blood sugar, high blood pressure and abnormal blood fats (bad LDL cholesterol and triglycerides) are common in people with diabetes and up risk of eye complications. Target the ABCs of diabetes care: good A1cBlood pressure and Cholesterol levels.