Patient selection: pediatric patient with diabetes mellitus
Risk factors for diabetic retinopathy:
(1) duration of diabetes
(2) elevated blood pressures or hypertension
(3) poor glycemic control, which is associated with elevated glcyated proteins
(4) lipid disorders, including low HDL
(5) genetic or familial predisposition
(6) early signs of atherosclerosis
(7) increased caliber of retinal blood vessels
Screening eye exams are started based on the age of the child and the duration of diabetes. Recommendations vary, but exams can start at 9 years of age if the patient has had diabetes for 3-5 years. Testing in older patients should start after 2 years of the initial diagnosis of diabetes. Screening can be conducted every 2 years, or more often if there is evidence of early retinopathy.
