Diabetic retinopathy (DR), the most common microvascular complication of diabetes and a leading cause of vision loss, is projected to increase at an alarming rate. Although much is known about DR among adults, data on the epidemiology of DR in youth are limited. A recent study1 found the prevalence of DR in a cohort of more than 2000 American youths (<20 years old) with diabetes to be 6% in those with type 1 diabetes and 9% in those with type 2 diabetes and even higher in minority populations. Because the prevalence of diabetes among youth, particularly those with type 2 diabetes, is reaching epidemic proportions,2 we will likely see the rates of DR in this population increase even higher.