A District Screening and Treatment Service for Diabetic Retinopathy

Abstract

A District Screening and Treatment Service for diabetic retinopathy using diabetic clinic staff is described. From 1978 to 1984 a total of 1195 diabetics entered the screening programme in a district with a population of 136 700. From 1982, when laser treatment became available locally, the average number of patients from the district requiring treatment for the first time per year was 14.0 for proliferative retinopathy and 11.3 for maculopathy. The laser was also used to treat patients from two other districts and the results of treatment from all three districts are reported. Regression of new vessels was achieved in 86% of 72 patients with proliferative retinopathy but 12 of these were also seen at the regional eye centre. Visual acuity was the same or better in 79% of the 104 eyes in 76 patients treated for maculopathy. Effective treatment can be given by a trained hospital practitioner at district level. This reduces demands on the regional centre but good liaison is necessary for difficult cases.

Public health and prevention of blindness in diabetes

“…Since patients have no or minimal symptoms of early sight threatening retinopathy, the only way to diagnose sight threatening retinopathy in its early stages, and ensure the optimal timing of treatment, is to systematically look for this disease through screening examinations. This approach started in the 1980s, and has enjoyed enormous success [5,11,12]. Diabetic patients were scheduled for an annual screening for retinopathy, either through a standard eye examination with dilated pupils by an ophthalmologist, or through fundus photography, where the images were read by expert ophthalmologists.…”