Do routine eye exams reduce occurrence of blindness from type 2 diabetes?
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Screening eye exams for patients with type 2 diabetes can detect retinopathy early enough so treatment can prevent vision loss. Patients without diabetic retinopathy who are systematically screened by mydriatic retinal photography have a 95% probability of remaining free of sight-threatening retinopathy over the next 5 years. If background or preproliferative retinopathy is found at screening (Figure), the 95% probability interval for remaining free of sight-threatening retinopathy is reduced to 12 and 4 months, respectively (strength of recommendation [SOR]: B, based on 1 prospective cohort study). A reliably sensitive screening exam requires mydriatic retinal photography augmented by ophthalmoscopy when photographs are inconclusive (SOR: A, based on a systematic review). For patients with diabetes not differentiated by type, photocoagulation significantly decreases visual deterioration and reduces the chances of blindness (SOR: A, based on randomized controlled trials [RCT]).
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