WHY WE SCREEN

GETTING STARTED

WHY WE SCREEN

Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States (NIH, 2015). This disease is characterized by microaneurysm formation and intraretinal hemorrhages in the eye, leading to complete vision loss (AAO.org, 2014). Diabetic patients who have high A1C levels and hypertension are at high risk for developing retinopathy. For the patient, retinopathy usually does not present any noticeable symptoms until the disease has caused significant damage to small blood vessels in the eye. Symptoms include blurred vision, floaters/flashes, and sudden loss of vision.

With the right strategy diabetic retinopathy can be identified in the eye prior to the onset of symptoms and before irreparable retinal damage. The first stage to preventing and treating diabetic retinopathy involves educating the diabetic patient and their family early about the symptoms and causes of diabetic retinopathy. A recent study found that 40% of American adults with diabetic retinopathy were unaware of what their disease was (Skaggs 2017). This highlights the importance of educating diabetic patients on the risks of high A1C levels and hypertension as it relates to eyesight. It is very important that patients properly manage their diabetes in order to prevent retinopathy.

The second stage involves regular retinal examinations using a non-mydriatic or mydriatic fundus camera. These retinal devices can identify retinopathy in its earliest stages before it causes any significant retinal damage. Resulting retinal images are read by licensed and trained offsite reviewers who can diagnose and recommend treatment for retinopathy. Treatment includes better diabetic management for mild retinopathy through medication and behavior change and surgery for more advanced cases. Treatments are more effective during the early stages of retinopathy. Any damage that is identified in the retinal images is a sign of end-organ disease, and treatment can slow end-organ disease found in the kidneys and feet. The American Diabetes Association recommends that diabetic patients receive a retinopathy screening once per-year—more depending on the patient’s condition (Solomon, 2017).

Telemedicine fundus photography is a cost-effective and convenient way to screen patients for retinopathy. This process involves a trained photographer screening a patient for retinopathy using a fundus camera. The resulting retinal images are sent to an off-site ophthalmologist who reads the images and makes a recommendation/ diagnosis. Should any problems be identified in the patient’s retinal images, the patient is referred for an in person examination with an ophthalmologist.