Samuel C. Lee, Vivian S. Lee, Elisa T. Lee
Over one-third of adult Native Americans in Oklahoma have noninsulin-dependent diabetes mellitus, and hence this population is at significant risk for diabetic eye disease and subsequent visual impairment. One of the leading causes of the visual impairment is diabetic retinopathy. A large-scale epidemiologic study of diabetes (including diabetic retinopathy through eye examinations and fundus photography) in American Indians in Oklahoma was conducted by Kelly West  and Elisa Lee  over a period of 30 years (1972-1992) involving 1,012 Indians. 1.n this study 824 fundus photographs were taken from the subjects and manually examined and graded.