In NIDDM, fundus examination is done:

A i.e. At the time of diagnosis Feature Insulin Dependent DM (Formerly Type I DM) Non-Insulin Dependent DM (Formerly Type II DM) Usual Age at Diagnosis 10-20 yrs 50-70 yrs Period of Latent disease Less More Incidence of DR More (40%) Less (20%) Incidence of PDR Incidence of proliferative DR is more Less Onset DR rarely develops within 5 years of the onset of diabetes or before pubeyQ All most all patients with Type I diabetes (IDDM) develop retinopathy in about 15 years. About 5% of type 2 (NIDDM) diabetics have DR at presentation. Risk factor Duration of diabetes is most impoant risk factor Q Risk of retinopathy increase with the duration of diabetes, accompanying hypeension and smoking. Q Initial examination Ophthalmoscopic examination within 3 years of diagnosisQ Ophthalmoscopic examination at the time of diagnosis Q Follow-up Then recommendations for periodic fundus examination are as follows: - Every yearly, till there is no diabetic retinopathy or there is mild non proliferative DR (NPDR) - Every 6 monthly, in moderate NPDR - Every 3 monthly, in severe NPDR - Every 2 monthly, in PDR with no high risk characteristic Involvement of fovea by edema & hard exudates or ischemia (diabetic maculopathy) is the most common cause of visual impairment in diabetic patients paicularly those with type 2 diabetes (NIDDM)