Are Current Eye Screening Guidelines Missing Diabetic Eye Issues in Youth?

Posted 04/12/2017 | By HealthCorps

Unless a child is born blind, eye issues and loss of vision may seem many decades away.   A large national study by researchers at the University of Michigan Kellogg Eye Center suggests that current screening methods and guidelines may be missing diabetic retinopathy..

The research suggests that more than one in five or 20 percent of kids with type 1 diabetes, and seven percent of kids with type 2 diabetes have a diagnosis of “diabetic retinopathy.”  This condition involves weakening of the walls of the eye’s blood vessels and can occur after exposure to higher blood sugar levels.  In fact, the research showed that in a review of 4,008 pediatric cases, children who were as young as six years old showed signs of proliferative retinopathy, a more advanced version of this eye disease.

The study, which enrolled subjects who were twenty one or younger, wanted to see if current guidelines and methods were identifying diabetic retinopathy in time to preserve children’s eyesight and halt progression of the disease process.  The also wanted to make sure that at-risk kids were being identified.

From the data, it was clear that kids with poorly controlled blood sugar levels were jeopardizing their vision.  Early stages of diabetic retinopathy may not have symptoms, so dilating the eyes and having an eye doctor examine the retina is crucial to early detection.  One reason it’s so important to screen patients with prediabetes or diabetes on a regular basis, is to track eye vessel changes, and intercept damage to the retina.

Pediatric guidelines suggest a “first screening” between ages three to five.  Unfortunately, the research data showed that more than 18 percent of the subjects with type 1 diabetes had already received a diagnosis of some level of diabetic retinopathy.  That speaks to a missed opportunity of intercepting the disease at its earliest stages.  This finding also suggests that screening for prediabetes and diabetes may have to happen at a much younger age, considering the rates childhood obesity, which is strongly linked to type 2 diabetes.

The researchers suggest that finding new ways to capture patients early and screen for diabetes and for associated eye issues is important.  Telemedicine may be one avenue to screen patients in remote locations for eye checks, using computer cameras that can be developed to take highly sophisticated photos which can be transmitted to eye specialists who are not local to the community.

If there is a family history of obesity or diabetes, and a strong likelihood that offspring will pattern after their parents, earlier eye screening is likely indicated.

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