Many Kids With Diabetes Aren’t Getting Recommended Eye Exams
What to Know
Diabetic retinopathy affects nearly 100 million people with diabetes worldwide. It is the leading cause of blindness among adults. The condition can begin in childhood and adolescence. At first, it progresses without symptoms, so people may not know they have it. That makes regular testing imperative. According to American Diabetes Association (ADA) guidelines, regular exams should start within five years of diagnosis of type 1 diabetes and at diagnosis for type 2 diabetes. An ophthalmologist will do an eye check at least once every two years after that. Recommendations are slightly different for kids: Those who have had type 1 diabetes for three to five years should get a comprehensive eye exam at age 10 or after puberty, whichever comes first. Follow-up exams are recommended every year or two years. (There are currently no retinopathy guidelines for kids with type 2.) This study evaluated the rates at which young people with diabetes received comprehensive eye exams.
Researchers reviewed the medical records of 5,453 people with type 1 diabetes and 7,233 people with type 2 diabetes—all of them 21 or younger and living in the United States—to determine how many had had their eyes examined for diabetic retinopathy.
Overall, 64.9 percent of young people with type 1 diabetes and 42.2 percent of those with type 2 diabetes had had an eye exam within six years of being diagnosed. African American and Latino youths were, respectively, 11 percent and 18 percent less likely than white youths to have had an eye exam. Income also played a role: As household incomes decreased, children became less likely to have had an eye exam.
Many children diagnosed with diabetes do not receive eye exams as recommended by the American Diabetes Association and other medical organizations. That increases their risk of vision loss from diabetic retinopathy, a complication of diabetes. The researchers call for improved methods to ensure adequate screening for diabetic retinopathy, especially among minority and lower-income families. They also say that their results may underestimate the number of children who receive thorough eye exams because they examined records from a single health insurance plan. Consequently, their results may not apply to plans that offer different types of diabetes management programs.
“Ophthalmic Screening Patterns Among Youths With Diabetes Enrolled in a Large US Managed Care Network.” Sophia Y.Wang, MD; Chris A. Andrews, PhD; ThomasW. Gardner,MD, MS; MichaelWood, MD; Kanakadurga Singer, MD; Joshua D. Stein, MD, MS. JAMA Ophthalmology, published online March 23, 2017