What is the recommended frequency for performing a diabetic foot examination and a comprehensive eye examination, specifically an ophthalmologic (eye) exam, in patients with diabetes mellitus (DM)?

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Last updated: May 20, 2025View editorial policy

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From the Guidelines

For people with diabetes, it's recommended to have a comprehensive foot exam performed by a healthcare provider at least once a year, and to perform self-examinations of your feet daily, as stated in the 2023 standards of care in diabetes 1. The annual professional foot exam should include inspection, assessment of pulses, and testing for loss of protective sensation, as outlined in the 2023 guidelines 1. Daily self-exams involve checking for cuts, blisters, redness, swelling, or nail problems.

Key Points for Foot Exams

  • Perform a comprehensive foot evaluation at least annually to identify risk factors for ulcers and amputations 1.
  • The examination should include inspection of the skin, assessment of foot deformities, neurological assessment, and vascular assessment, including pulses in the legs and feet 1.
  • Individuals with evidence of sensory loss or prior ulceration or amputation should have their feet inspected at every visit 1.

Eye Exams

For eye exams, adults with type 1 diabetes should have an initial comprehensive eye examination by an ophthalmologist or optometrist within 5 years of diagnosis, while those with type 2 diabetes should have this exam at the time of diagnosis, as recommended in the 2025 standards of care in diabetes 1.

Key Points for Eye Exams

  • After the initial exams, all diabetic patients should have yearly eye examinations, unless otherwise indicated by the presence of retinopathy or other eye problems 1.
  • More frequent eye exams may be needed if you have existing eye problems or if your doctor detects changes in your eyes 1.
  • Programs that use retinal photography with remote reading or the use of U.S. Food and Drug Administration–approved artificial intelligence algorithms can improve access to diabetic retinopathy screening, as noted in the 2025 guidelines 1.

These regular examinations are crucial because diabetes can cause serious foot complications like neuropathy and poor circulation, as well as eye problems like diabetic retinopathy, which can progress without symptoms until vision loss occurs, as highlighted in the 2023 standards of care in diabetes 1. Early detection through regular screening allows for timely intervention that can prevent serious complications.

From the Research

Diabetic Foot Exam and Eye Exam Frequency

There is no direct evidence in the provided studies to determine the frequency of diabetic foot exams and eye exams. However, the studies do discuss the importance of regular monitoring and treatment of diabetic retinopathy and macular edema.

Key Findings

  • The studies focus on the treatment of diabetic retinopathy and macular edema, including laser photocoagulation and anti-vascular endothelial growth factor (anti-VEGF) therapy 2, 3, 4, 5, 6.
  • Regular monitoring and treatment are crucial to prevent vision loss and manage diabetic retinopathy 2, 3, 4, 5, 6.
  • The frequency of eye exams may depend on the individual's risk factors and the severity of their diabetic retinopathy 3, 5.

Treatment and Monitoring

  • Laser photocoagulation is a common treatment for diabetic retinopathy, but anti-VEGF therapy has shown promising results in reducing retinal thickness and improving vision 2, 3, 4, 5.
  • Regular eye exams are essential to monitor the progression of diabetic retinopathy and adjust treatment plans accordingly 3, 5.
  • The American Diabetes Association recommends regular foot exams for people with diabetes to prevent and detect foot complications, but the provided studies do not specify the frequency of foot exams.

Note: There are no research papers to assist in answering the question of how often to perform a diabetic foot exam.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Laser photocoagulation for proliferative diabetic retinopathy.

The Cochrane database of systematic reviews, 2014

Research

The Evolving Treatment of Diabetic Retinopathy.

Clinical ophthalmology (Auckland, N.Z.), 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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