“An Integral Part of Management”: Making Retinopathy Screening More Accessible

Diabetic retinopathy is the leading cause of blindness in adults, but it also affects children with diabetes. Early detection with a retinal exam remains key in preventing this complication. The American Diabetes Association recommends annual screenings for children with Type 2 diabetes and annual screenings for children with Type 1 diabetes three to five years after their diagnosis. But previously, only about half of patients with diabetes got screened.

“Diabetes screening for retinopathy is an integral part of management for patients with Type 1 and Type 2 diabetes, but screening rates have remained low because it’s an additional appointment with either an optometrist or ophthalmologist,” says Amy Sanghavi Shah, MD, MS, a Cincinnati Children’s diabetes and endocrinology specialist and director of the Division of Diabetes and Endocrinology. “With an in-clinic method for screening patients, we can save time for families and reduce their burden.”

Introducing AI-Powered Eye Exams

In October 2022, the Division of Diabetes and Endocrinology at Cincinnati Children’s became one of the first institutions to use the Topcon NW400 with LumineticsCore® software for autonomous, artificial intelligence (AI)-powered screening of diabetic retinopathy in its pediatric Diabetes Center. Initially, the team followed a research protocol to test the camera’s feasibility for pediatric patients. The camera has already received approval from the United States Food and Drug Administration to use with adults.

“Once we found that patients liked the camera, and we could train clinic staff, we knew we could implement it in a clinical setting,” Shah says. “We started using it clinically in November 2023 and have taken over 700 images since then.”

Additionally, the team has confirmed the accuracy of hundreds of scans.

The camera is unique because in less than 60 seconds, it takes two photos of each eye and completes a preliminary read of the results, with the help of AI. This type of screening doesn’t require eye dilation, unlike comprehensive eye examinations, which makes it quick and feasible for pediatric patients.

“To start, we had the AI do the preliminary read, and then the ophthalmologist reread it,” Shah says. “After hundreds of successful results, we’ve confirmed that the camera and AI reads are reliable, so now, Ophthalmology doesn’t have to reread every image.”

Improving Diabetic Retinopathy Screening Rates

The ability to screen patients in the Diabetes Center without a separate appointment or eye dilation has already improved diabetic retinopathy screening rates—increasing from 50% to over 90% patient completion. It helps that patients can receive the exam they need.

“Now, instead of telling everyone to see Ophthalmology regardless of if there’s a concern of not, we can send only the patients whose screens are positive to Ophthalmology,” Shah says. “If you’re already coming to the Diabetes Center three or four times a year, you just don’t have time for extra visits.”

Very few pediatric clinics in the country are using this convenient screening tool, but implementation can have real benefits for patients with diabetes and their families.

“For endocrinologists, this in-clinic exam is an effective way to accomplish screening for diabetic retinopathy without sending patients to more than one place,” Shah says.

(Published November 2025)

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