Purpose To measure the population prevalence of diabetic eye disease in an
inner city setting.
Methods As part of a systematic screening programme all adult diabetic pati
ents in four general practices were invited to attend for slit-lamp biomicr
oscopy by a retinal specialist. Data on non-attenders were available from c
ommunity-based photography.
Results Of 395 diabetic patients identified, 326 attended biomicroscopy wit
h photographic data available on a further 31, giving a 90% compliance rate
. Point prevalence of diabetes in the target population was 12.4/ 1000. Dem
ographic data included: mean age 60 years (range 13-92 years); type of cont
rol: type I 49, type II insulin-requiring (IR) 40, type II non-insulin-requ
iring (NIR) 268. Prevalences were as follows: any retinopathy: of all diabe
tic patients 33.6%, type I 36.7%, type II IR 45.0%, type II NIR 31.3%; prol
iferative/ advanced: all 1.1%, type I 2.0%, type IT IR 0, type II NIR 1.1%;
clinically significant macular oedema: all 6.4%, type I 2.3%, type II IR 1
6.2%, type II NIR 5.7%. The percentage of patients with retinopathy requiri
ng follow-up by an ophthalmologist was 4.5%, and 9.2% had macular exudates
within 1 disc diameter of fixation or significant circinate maculopathy. Si
ght-threatening diabetic eye disease (STED) was found in 13.4%. A visual ac
uity of less than or equal to 6/24 in the better eye occurred in 12 (3.4%)
patients and of less than or equal to 6/60 in the better eye in 3 (0.8%).
Conclusions Compared with previous population studies, prevalences appear t
o have declined in type I, but remain high in type II diabetic patients and
especially in those requiring insulin.