Recommendations for those with type 1 diabetes and pediatric retinopathy1 are summarized on this slide The first ophthalmologic examination should be obtained once the child is 10 years of age and has had diabetes for 3-5 years (E) After the initial examination, annual routine follow-up is generally recommended; less frequent examinations may be acceptable on the advice of an eye care professional (E) Although retinopathy (like albuminuria) most commonly occurs after the onset of puberty and after 5–10 years of diabetes duration,2 it has been reported in prepubertal children and with diabetes duration of only 1–2 years Referrals should be made to eye care professionals with expertise in diabetic retinopathy, an understanding of the risk for retinopathy in the pediatric population, and experience in counseling the pediatric patient and family on the importance of early prevention/intervention121References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S42. Cho YH, Craig ME, Hing S, Gallego PH, Poon M, Chan A, Donaghue KC: Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006. Pediatr Diabetes 2011;12:682-689.