A newly diagnosed 52-year-old man with type 2 diabetes asks when his eyes will be examined. His 19-year-old cousin was diagnosed with type 1 diabetes last month and also asks about screening. What is the correct screening schedule for diabetic retinopathy in these two patients?

• A Both should be screened immediately at diagnosis and annually thereafter
• B Both should wait until visual symptoms develop
• C The 52-year-old starting 5 years after diagnosis and the 19-year-old at diagnosis
• D The 52-year-old at diagnosis and the 19-year-old starting 5 years after diagnosis ✓

Explanation

Type 2 diabetes is frequently present undetected for years, so retinopathy can exist at the time of diagnosis and examination is done at diagnosis, then annually if normal. Type 1 diabetes rarely shows retinopathy in the first five years, permitting the first dilated eye examination five years after onset, then annually. Waiting for symptoms is wrong because early proliferative disease is asymptomatic yet needs timely laser or antiVEGF treatment.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.