Results of a specialised diabetes retinopathy screening initiative in Cork have been published, showing that community-based screening programmes for diabetes can reduce both hospital visits and the serious complications associated with the disease. The results also suggest that many patients with sight-threatening retinopathy are not receiving any treatment.
The evaluation was carried out by the Department of Epidemiology and Public Health, University College Cork on behalf of the HSE South, in consultation with Diabetes in General Practice (DiGP) and the Association of Optometrists Ireland, to evaluate the screening initiative set up in Cork in 2011 to address the deficit in screening available in the community.
The report highlights that the initiative shows it is possible to address some of this deficit using existing resources in the community. The report also emphasises that the implementation of the proposed National Diabetic Retinopathy Screening Service is the optimum way to detect and treat diabetic eye disease into the future.
A total of 3,598 patients with diabetes were invited for screening by their GPs – GPs were members of the DiGP group – between February 1st and June 20th 2011, and 1,763 people had attended for screening (49 per cent) by September 21, 2011. From this group, sight-threatening retinopathy was detected in 11 patients, one of which required emergency/same day referral to on ophthalmology specialist. Six patients with sight-threatening retinopathy were not attending ophthalmology specialists at all.
Prior to this initiative, the majority of retinopathy screening in Cork had taken place at Cork University Hospital’s ophthalmology department.
“This community-based initiative maximised the use of existing community-based resources (optometry/ophthalmology clinics) to ensure easy access for patients and to allow specialist services to focus on treating confirmed eye disease,” said Ms Gabrielle O’Keeffe, General Manager, HSE Cork and Chairperson of the retinopathy sub-group.
“The screening programme aims to reduce the serious complications associated with diabetic eye disease. Locally-based opticians and opthalmologists facilitated the screening and referral process for those identified with diabetic eye disease.”
Dr Diarmuid Quinlan, Chair of the HSE South Diabetes Strategy Implementation Group, said that the evaluation has led to a number of recommendations to help inform the development of the National Diabetic Retinopathy Screening Service.
“Diabetic retinopathy can develop and progress without symptoms becoming obvious until significant damage has occurred. The HSE wishes to make the public aware of the risk of blindness from diabetic eye disease and the benefits of annual screening in early detection and treatment.”
In 2009, retinopathy screening was prioritised by the National Diabetes Programme, which was established under the governance of Dr Barry White, National Director of the HSE’s Quality and Clinical Care Directorate. One of the key objectives of the national programme was the establishment of a National Diabetic Retinopathy Screening Service. The national screening service is scheduled to be available nationwide to patients with diabetes in late 2012 and is currently undergoing a national commissioning process, according to the HSE.
