Has Your Child Been Screened for Diabetic Retinopathy?

Written by Dr. David Evans   Last modified on August 6, 2018

I’m sitting down to write this blog after reading the news about Senator John McCain’s unfortunate announcement that he’s been diagnosed with an aggressive brain tumor. A true American hero, Senator McCain has a decorated history of service in both the military and politics, so I join the growing chorus of support and well-wishers for him and his family as they evaluate treatment options.

The reason I mention this as the lead in a blog post about diabetic retinopathy relates to the manner with which the tumor was discovered. The 80-year old Senator was undergoing a routine physical exam when his doctors identified a clot above his eye that turned out to be a glioblastoma. Given the highly aggressive nature of this cancer, the prognosis isn’t good, but its discovery and the subsequent emergency surgery could very well extend the Senator’s survival chances by years. It also underscores the importance of routine health exams.

New research from Dr. Sylvia Wang of the Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, suggests that children and teens with type 1 or type 2 diabetes are not being screened regularly enough for diabetic retinopathy (DR), a serious eye disease and leading cause of blindness. The condition is often asymptomatic until it has progressed significantly, limiting the potential treatment options and risking patients’ vision health.

Organizations like the American Academy of Ophthalmology (AAO), the American Diabetes Association (ADA) and the American Academy of Pediatrics (AAP) have guidelines with regard to when children and teens with diabetes should be screened for diabetic retinopathy. These guidelines can fluctuate from organization to organization, and differ based on whether type 1 or type 2. For example, the ADA and AAP recommend that children over the age of 10 and 9 (respectively) get their first DR screening three to five years after diagnosis. Based on Dr. Wang’s study, more than 18% of children with type 1 diabetes have already developed DR by the time they get their first screening.

A broader, secondary study evaluated those aged 21 and under with type 1 and type 2 diabetes. It found that six years after an initial diagnosis, only 65% of type 1 and 42% of type 2 patients had received an eye examination. Given the importance of early detection in the treatment of diabetic retinopathy, this new research highlights a serious issue. A large percentage of young diabetics are at serious risk of diabetic blindness because they aren’t getting screened early enough.

In order to help safeguard these at-risk patients, steps need to be taken to ensure that all patients are aware of the importance of getting routine eye health checkups after their diabetes diagnosis. In addition to making improvements in the field of screening technologies, such as the expanded role that telemedicine can play, education can be a difference maker. A cohesive strategy shared amongst ophthalmologists, general practitioners and even endocrinologists to better educate diabetic patients about the risks of DR could mean the difference between healthy vision and significantly impaired sight, or even blindness.

Although Senator McCain is upbeat and has in fact survived cancer before (melanoma), the severity of this brain cancer cannot be understated. But his proactive action to get health screenings has undoubtedly bought him more time and should serve as a lesson to us all. If you are the parent of a child with diabetes who has not yet undergone a DR screening, it’s important that you speak with your doctor as soon as possible about scheduling an exam. It could very well save your child’s vision.

To learn more about this research, check out the recent article from Eyeworld.org.