When should a case of Non-Insulin Dependent Diabetes Mellitus (NIDDM) with a history of diabetes for one year, undergo an ophthalmic examination?
**Core Concept**
Diabetic retinopathy is a common complication of diabetes, particularly in patients with Non-Insulin Dependent Diabetes Mellitus (NIDDM). Early detection and treatment of diabetic retinopathy can prevent vision loss. The American Diabetes Association recommends a comprehensive eye examination for patients with diabetes at the time of diagnosis and annually thereafter.
**Why the Correct Answer is Right**
The correct answer is based on the recommendation by the American Diabetes Association for patients with diabetes to undergo a comprehensive eye examination annually. This is because diabetic retinopathy can progress rapidly, and early detection is crucial for preventing vision loss. Patients with NIDDM should undergo an ophthalmic examination one year after diagnosis to assess for any signs of diabetic retinopathy. The examination should include a dilated retinal examination to evaluate for microaneurysms, hemorrhages, and hard exudates.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because patients with NIDDM do not require an ophthalmic examination at the time of diagnosis. This is because the onset of diabetic retinopathy is typically gradual and may not be apparent at the time of diagnosis.
**Option B:** This option is incorrect because patients with NIDDM do not require an ophthalmic examination every 3 months. This frequency is more typical for patients with a history of proliferative diabetic retinopathy or those with a high risk of vision loss.
**Option C:** This option is incorrect because patients with NIDDM do not require an ophthalmic examination only when symptoms are present. Diabetic retinopathy can be asymptomatic, and patients should undergo regular examinations to detect any signs of the disease.
**Clinical Pearl / High-Yield Fact**
Patients with diabetes should undergo a comprehensive eye examination annually to detect and treat diabetic retinopathy early. This is particularly important for patients with NIDDM, who are at increased risk of developing diabetic retinopathy.
**Correct Answer:** D.