A yearly dilated fundoscopic examination is recommended, beginning at diagnosis in patients with type 2 diabetes and after 3-5 years in those with type 1 diabetes. It is recommended that this examination be done by an ophthalmologist or optometrist who is knowledgeable and experienced in the diagnosis of diabetic retinopathy.
Comment: When to begin screening children with type 1 diabetes is a controversial topic. Although previously it was felt that duration of diabetes prior to puberty was not clinically significant, there is now increasing evidence that the duration of diabetes should be considered regardless of pubertal status, and the screening of all patients with type 1 after 3-5 years of diabetes is recommended.
Yearly screening allows die detection of diabetic retinopathy at its earliest stages, permitting close follow-up and laser treatment, as appropriate. It also allows other types of diabetes-associated eye disease to be identified, such as cataracts, as well as common eye problems such as glaucoma. The availability of laser therapy for diabetic retinopathy has made a significant difference in preserving eyesight. Moreover, the detection of eye disease early in the course, when there is minimal to no functional disruption, offers the additional opportunity to s
motivate the patient to strive for optima) blood glucose and blood-pressure control to hopefully prevent more serious retinopathy.
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