Diabetic retinopathy screening in the public sector in India: What is needed?

Abstract

India has been witnessing an epidemic of diabetes for several years now. A large proportion of patients with undiagnosed and poorly controlled diabetes are at great risk of developing diabetic retinopathy (DR) and irreversible blindness. The goal of DR screening is to identify people with sight-threatening DR early so that prompt treatment can be initiated, and blindness can be prevented. Systematic DR screening is essential to identify disease early, and a national effort for the same is required. We adopt a health system approach to outline the actions that need to take place for effective DR screening in the public sector in India. We discuss the role of national leadership, needs assessment, finalization of DR screening and referral pathway, trainings, strategies to improve the uptake, allocation of roles and responsibilities, public-private partnerships, quality control, and financing.

Examining the Role of Telemedicine in Diabetic Retinopathy

“…Those diagnosed with DR at the camps were subsequently referred to a public tertiary care hospital [93]. Such initiatives could be further supported using government contracts with NGOs and other private organizations that already administer DR screening services [105]. Moreover, the costs of a DR screening program, including equipment, training personnel, quality assurance, and data security, will be substantial [105].…”

“…Such initiatives could be further supported using government contracts with NGOs and other private organizations that already administer DR screening services [105]. Moreover, the costs of a DR screening program, including equipment, training personnel, quality assurance, and data security, will be substantial [105]. Cooperation between the public sector and private enterprises for the development and provision of these services will be necessary for successful and sustainable DR screening initiatives.…”

Artificial intelligence for diabetic retinopathy screening: beyond diagnostic accuracy

“…Even though recent advances have been occurring, DR screening is a large unmet need also among other countries where enormous contingents of individuals with diabetes dwell (4), as is the case of the United States, where less than half of such individuals adhere to eye screening guidelines (5,17), and also of other low to middle income countries, where the availability of screening programs and adherence rates are even lower (4,(18)(19)(20)(21). In this sense, the study by Yao Yang and collaborators is very relevant not only for the local setting, but on a global scale.…”