DETECTION OF SIGHT-THREATENING DIABETIC EYE DISEASE

Blindness due to diabetes mellitus is potentially preventable in the m ajority of patients. Early detection of sight-threatening changes is a ssociated with a better outcome, indicating the need to screen for ret inopathy. At least 50% of diabetic patients do not attend a hospital, so that diabetologists and ophthalmologists are unable to screen the d iabetic population comprehensively. Although in theory all patients ha ve access to general practitioners, these may lack training or confide nce to screen for retinopathy. Hospital based or community optometrist s using direct ophthalmoscopy or slit lamps and technicians performing fundus photography are alternatives which may be more effective. Furt her studies are required to examine the effectiveness of optometry scr eening. Initial studies using fundus photography raised concerns about the sensitivity of the technique, but these have been partially addre ssed by improvements in methodology and technology. As well as technic ological effectiveness, factors affecting patient uptake of screening services still need to be addressed.