ATLANTA - Sunday Simmons remembers the first time in a long time that she got her eyes screened.
"The only thing I (could) see was bright lights," Simmons says. "I was like a deer in headlights."
She had just come to Grady Memorial Hospital in Atlanta as a new patient, freshly-diagnosed with type 2 diabetes.
And, Simmons could tell that her eyesight wasn't what it used to be.
"It was like cloudiness, I couldn't see," she says. "I couldn't see small letters."
That's a troubling sign to Dr. Yousuf Khalifa, Chief of Ophthalmology at Grady.
"So when you start getting blurry vision and you're diabetic, that's a very late stage of diabetes," Dr. Khalifa says.
Simmons was diagnosed with diabetic retinopathy, one of the leading causes of blindness in diabetics.
Over time, Dr. Khalifa says, chronic high blood sugar can damage tiny blood vessels in the retina, the light-sensitive tissue that lines the back of the eye.
That disruption in blood flow can cause the blood vessels to swell, leak and grow, damaging vision.
"Diabetic retinopathy has different stages," Khalifa explains. "There is mild, moderate, severe and then proliferative. We want to catch patients early on."
The best way to do that is to screen diabetics once a year with a dilated eye exam.
But, that presents a big challenge.
Grady Health System has about 15,000 diabetic patients.
Dr. Khalifa says there is no way the Grady Eye Clinic would be able to screen that many patients with a dilated eye exam.
So, last November, Grady began offering teleretinal imaging screenings to all diabetics during their routine appointments.
That's how Sunday Simmons found herself sitting in front of the big machine as it photographed the back of her eye.
"I call it Superman," Simmons says. "It sees everything."
The machines, placed in Grady's primary care clinics, don't require dilation.
Screening takes about 5 to 10 minutes and is automatically added into the patient's appointment once a year.
"You show up, you're due for an exam, an alert fires in your electronic medical record," Khalifa says. "And, we don't miss you."
The images are then uploaded and reviewed by an off-site ophthalmologist.
who alerts a Grady eye specialist and the patient's primary care doctor if there is a problem.
Over the last 7 months, about 3,800 diabetic patients have been screened through the teleretinal program.
"We're finding about 30 to 40 percent of our patients have some sort of diabetic retinopathy on the photographs, so that's a pretty high percentage," Khalifa says.
About 3 percent have the most advanced form of the disease.
Sunday Simmons' exam flagged a problem, so she was given an emergency appointment to get her on a treatment plan.
"In order for me to help myself, they were telling me, "You're going to stop smoking," she says.
Simmons says she hasn't quit yet, but she's trying to cut back on smoking.