Type 1 diabetes mellitus (T1DM) is considered an autoimmune disease in which the function of pancreatic β-cells which secrete insulin is impaired. Diabetic retinopathy (DR) is the most common complication of T1DM. Several authors recommend that clinical ophthalmic examinations as a screening method for DR be started 3–5 years after a diagnosis of T1DM, followed by annual reviews for pediatric patients older than 9 years. On the other hand, another opinion recommends both clinical fundus examination and fundus photography annually for all T1DM patients aged 12 years and older. Fundus photography is the most effective screening method for DR, with high sensitivity and accuracy. In many countries, photographic screening of children with T1DM is recommended to commence at the age of 10 years regardless of the duration of T1DM. Fundus photography and direct ophthalmoscopy must be considered as golden tools for screening DR. Further larger, multi-center studies are recommended to evaluate the accuracy of fundus photography versus direct ophthalmoscopy.