Artificial intelligence-powered cameras can now detect diabetic retinopathy, the leading cause of blindness in working-age adults, in about 30 seconds without requiring pupil dilation or a specialist's involvement. Cleveland Clinic has installed these AI-enabled fundus cameras across its Cole Eye Institute locations and selected primary care and endocrinology clinics, fundamentally changing how patients with diabetes access critical eye screening .

What Is Diabetic Retinopathy and Why Does Screening Matter?

Diabetic retinopathy occurs when high blood sugar damages blood vessels in the retina, potentially leading to vision loss or blindness. The condition is particularly dangerous because patients often have no symptoms in early stages, meaning many people don't realize they have it until significant damage has occurred. National screening rates for diabetic retinopathy hover between 50% and 70%, leaving millions of patients at risk .

Traditional screening requires patients to visit an ophthalmology clinic for a dilated eye exam, a process that can take one to two hours depending on clinic volume. This inconvenience creates a major barrier to care, especially for patients who already struggle with access to healthcare appointments.

How Do These AI Cameras Actually Work?

The new nonmydriatic cameras, meaning they don't require pupil dilation, operate with remarkable simplicity. A patient sits at a tabletop device, places their chin in a rest, and a technician or support staff member initiates the scan using a touch screen. The camera automatically moves and focuses itself to capture two images of each eye: one of the optic nerve and one of the macula, the area responsible for central vision .

The AI software then evaluates these images in seconds and provides one of three results:

• No diabetic retinopathy detected: Patient can follow up with their primary care provider in one year
• More than mild diabetic retinopathy detected: Patient is scheduled for comprehensive ophthalmology evaluation
• Exam quality insufficient: Results are inconclusive, often due to severe cataracts or other eye pathology

The entire process takes only minutes, and results automatically flow into the patient's electronic medical record with no additional provider documentation required .

How to Get Screened for Diabetic Retinopathy at Cleveland Clinic?

Cleveland Clinic has streamlined the screening process to remove common barriers to care:

• Same-day screening: Patients can complete AI diabetic retinopathy screening during their primary care or endocrinology visit without scheduling a separate appointment
• Adjacent clinic access: For patients whose primary care visit is not at a location with a camera, same-day screening is available at an adjacent ophthalmology clinic immediately after their appointment
• Staff-led process: Nurses and medical assistants trained on the cameras conduct the screening, freeing ophthalmologists to focus on patients with active disease requiring treatment
• No dilation needed: The nonmydriatic technology eliminates the need for dilating drops, reducing appointment time and allowing patients to drive home immediately

"Cleveland Clinic cares for tens of thousands of patients with diabetes, and a large proportion of them do not have dilated eye exams, which are critical to prevent vision loss from diabetic retinopathy. However, each year, many of these patients without retinopathy are referred to ophthalmology for a dilated eye exam for retinopathy screening. Those exams require evaluation by a provider and can take one to two hours, depending on how busy the clinic is that day. With our new fundus cameras, we can screen patients in a fraction of the time," said Sumit Sharma, MD, a vitreoretinal surgeon at the Cole Eye Institute.

Sumit Sharma, MD, Vitreoretinal Surgeon at Cleveland Clinic Cole Eye Institute

What Impact Could This Have on Screening Rates?

The convenience factor addresses one of healthcare's most persistent problems: patients not completing recommended preventive care. By removing the need for a separate ophthalmology appointment, transportation barriers, and time away from work, Cleveland Clinic expects more patients to actually get screened .

The cameras can screen approximately 85% of patients without dilation when used in primary care or endocrinology settings. When used in ophthalmology offices where dilated exams can be performed immediately if results are inconclusive, the screening rate reaches 95% . This matters because early detection of diabetic retinopathy, even in asymptomatic patients, can prevent vision loss through timely treatment.

"National rates for DR screening often hover between 50% and 70%. There is a clear need to improve screening rates, as DR is the leading cause of blindness in working-age adults. Anything we can do to make the screenings more convenient will make patients more likely to complete them," noted Kevin Pantalone, DO, Director of Diabetes Initiatives at Cleveland Clinic.

Kevin Pantalone, DO, Director of Diabetes Initiatives at Cleveland Clinic

Why This Matters Beyond Cleveland Clinic?

This deployment represents a broader shift in how healthcare systems can use AI to address screening gaps. The technology doesn't replace ophthalmologists; instead, it redirects their expertise toward patients who actually need treatment rather than routine screening. This efficiency gain allows specialists to see more patients with active disease while making screening accessible to the broader diabetes population .

For patients, the impact is immediate and tangible. Someone with diabetes can now get their annual retinopathy screening during a routine endocrinology visit, receive results in 30 seconds, and know whether they need specialist care. Those without retinopathy can return to their primary care provider for follow-up in one year. This removes a significant barrier to preventive care that has historically left millions of patients unscreened and at risk for preventable blindness.