<unk>  is detected during an eye examination that includes: * Visual acuity test: Uses an eye chart to measure how well a person sees at various distances (i.e., visual acuity). * Pupil dilation: The eye care professional places<unk> ops into the eye to dilate the pupil. This allows him or her to see more of the retina and look for signs of<unk> . After the examination, close-up vision may remain blurred for several hours. * Ophthalmoscopy or fundus photography: Ophthalmoscopy is an examination of the retina in which the eye care professional: (1) looks through a slit lamp biomicroscope with a special magnifying lens that provides a narrow view of the retina, or (2) wearing a headset (indirect ophthalmoscope) with a bright light, looks through a special magnifying glass and gains a wide view of the retina. Hand-held ophthalmoscopy is insufficient to rule out significant and treatable<unk> . Fundus photography generally captures considerably larger areas of the fundus, and has the advantage of photo documentation for future reference, as well as availing the image to be examined by a specialist at another location and/or time. * Fundus Fluorescein angiography (FFA): This is an imaging technique which relies on the circulation of fluorescein dye to show staining, leakage, or non-perfusion of the retinal and choroidal vasculature. * Retinal vessel analysis detects abnormalities of the autoregulation of small retinal arteries and veins in<unk>  patients even before the manifestation of<unk> . Such an impairment of retinal responsiveness is seen as one of the earliest markers of vascular dysfunction in diabetes possibly indicating subsequent risk of stroke. * Optical coherence tomography (OCT): This is an optical imaging modality based upon laser beam interference. It produces cross-sectional images of the retina (B-scans) which can be used to measure the thickness of the retina and to resolve its major layers, allowing the observation of swelling. The eye care professional will look at the retina for early signs of the disease, such as: # leaking blood vessels, # retinal swelling, such as macular edema, # pale, fatty deposits on the retina (exudates)signs of leaking blood vessels, # damaged nerve tissue (neuropathy), and # any changes in the blood vessels. If macular edema is suspected, OCT and sometimes retinal angiography (FFA) may be performed.<unk>  also affects microcirculation thorough the body. A recent study showed assessment of conjunctival microvascular hemodynamics such as vessel diameter, red blood cell velocity and wall shear stress can be useful for diagnosis and screening of<unk> . Furthermore, the pattern of conjunctival microvessels was shown to be useful for rapid monitoring and diagnosis of different stages of<unk> . Google is testing a cloud algorithm that scans photos of the eye for signs of retinopathy. The algorithm still requires FDA approval. According to a<unk> SS user manual, poor quality retina images used for screening (which may apply to other methods) may be caused by cataract, poor dilation, ptosis, external ocular condition, or learning difficulties. There may be artefacts caused by dust, dirt, condensation, or smudge. Screening In the UK, screening for<unk>  is part of the standard of care for people with diabetes. After one normal screening in people with diabetes, further screening is recommended every two years. In the UK, this is recommended every year. Teleophthalmology has been employed in these programs. In The U.S, a current guideline for<unk>  is recommendation of annual dilated exams for all patients with diabetes. There are barriers to recommended screening that is contributing to the disparity. Such as the patient factor which includes education about<unk>  and the availability of the treatment. The health care system also contributes to the disparities in<unk>  screening, which includes insurance coverage, long waiting time for the appointment and difficulty scheduling appointments which makes the person less likely to screen. Provider factors also influence the barrier to screening which is a lack of awareness of the screening guidelines, skills or having the right tools to perform eye exams which can affect the diagnosis and treatment. A cross-sectional study showed that when physicians treating black patients had more difficulty providing proper subspecialty care and diagnostic imaging for the patients. There is evidence to support interventions to improve attendance for<unk>  screening. These might be specifically targeted at<unk>  screening, or could be general strategies to improve diabetes care. In addition, significant differences in genetic risk for<unk>  raises the possibility of risk stratification and screening targeted to individuals with high genetic risk for<unk>  in the population.
Diabetic retinopathy
Autoimmune retinopathy
Hypertensive retinopathy
Radiation retinopathy
Photic retinopathy
Retinal vasculitis
Autoimmune optic neuropathy
Sickle cell retinopathy