Ophthalmologists generally consider diabetic retinopathy (DR) to be rare in youths with diabetes. However, recent data from the SEARCH for Diabetes in Youth (SEARCH)1 and Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY)2 studies demonstrated alarming rates of DR after a mean diabetes duration of only 12 years and at a mean age of 26.4 years.2 In the SEARCH study, 52% of youths with type 1 diabetes (T1D) had DR, and in the SEARCH and TODAY studies combined, 49% to 55% of those with youth-onset type 2 diabetes (T2D) had DR. For participants with T2D, at a mean 7.5 years after diagnosis, the standardized prevalence of DR was 31.0%, increasing to 55.7% at a mean 12.4 years after diagnosis.