An Optical Practice Based Diabetic Eye Screening Programme

Abstract

In many cases, blindness due to diabetic retinopathy can be prevented provided treatment with laser photocoagulation is used at the correct time. A screening programme is required to identify cases of sight threatening retinopathy. An optical practice based diabetic eye screening programme has been established in Dorset. The optometrist undertaking the examination is paid a fee. The findings are recorded on a coded form and sent to the hospital diabetologist who recalls positive cases. Seventy-six optical practices have joined the scheme and 3224 patients have been screened in the first 6 months (Dorset population 655,000). In the Poole area (population 230,000), 1922 patients were screened and 129 (6.7%) were recalled in 6 months. Outcome of 3 months screening, identified 59 recalls. Referral to the opthalmologist was made in 15 cases for potentially sight threatening retinopathy, 14 cases were followed in the diabetic clinic for significant background retinopathy, and 24 cases were returned to the annual screening in the optical practices. Six cases where the patients either failed or were unable to attend were reviewed by the GP. An optical practice based diabetic eye screening programme has been successful in screening a large number of patients.

Primary care and ophthalmology in the United Kingdom

“…These were subsequently found to be indispensable and were made permanent in the Health Services and Public Health Act 1968 and renamed the General Ophthalmic Services (GOS). Over the years, the responsibilities of the GOS were increased and they now include contact lens work, glaucoma screening, 22 23 selective diabetic retinopathy screening [24][25][26] and experimental trials of the follow up of glaucoma patients, 27 cataract surgery, 28 and the referral of cataract patients directly to the hospital. 29 Extending the optometrists' role to treatment of disease and becoming the principal providers of primary ophthalmic care in the community has been proposed 20 and the prescription of therapeutic drugs by optometrists is being considered, 30 but these suggestions have not been approved by the Royal College of Ophthalmologists.…”

Visual impairment and blindness in Europe and their prevention

“…The industrialised countries of western Europe, together with countries such as the Czech Republic, Estonia, Hungary, Poland, and Slovakia, have been considering diabetic retinopathy among the leading causes of avoidable blindness in their population during the last decades. [97][98][99][100][101][102][103][104][105][106][107] In the above mentioned parts of Europe, early diagnosis and systematic follow up of diabetic patients have been promoted. In rural areas of former socialist countries of the Balkan Peninsula, and in some former USSR member countries, healthcare services providing early detection and/or retinal laser treatment are not often available.…”

A countywide primary care annual audit fails to demonstrate an improvement in diabetes care between 1996 and 2001

“…[14][15][16] The proportion of patients undergoing process of care in Dorset is similar to these studies, and was consistent with previously reported percentages of patients undergoing the process of care by GPs in Poole. 12 The numbers of patients undergoing retinal screening seems low compared with previously published data on the optometrist-based eye screening programme in Dorset, 18 but discussion with local GPs suggests that the data collection process may cause difficulties, and that we are probably underestimating the numbers of patients having their eyes screened. However, this system of data collection has not changed between 1996 and 2001, so the fall in numbers of patients having their eyes screened reported in our study may not be due to this problem.…”