Use of eye care services by people with diabetes: the Melbourne Visual Impairment Project

Abstract

Aim-The use of eye care services by people with and without diabetes was investigated in the Melbourne Visual Impairment Project (VIP), a population based study of eye disease in a representative sample of Melbourne residents 40 years of age and older. Methods-A comprehensive interview was employed to elicit information on history of diabetes, medication use, most recent visit to an ophthalmologist and optometrist, and basic demographic details. Presence and extent of diabetic retinopathy was determined by dilated fundus examination. 2 3 There is a high rate of vision loss due to diabetic retinopathy when diabetes has been present for more than 30 years, with approximately two thirds of people having lost vision after 35 years of diabetes. Results-The 4Current treatments, if appropriately timed and rigorously applied, may be eVective in preventing up to 98% of severe visual loss and blindness due to diabetic retinopathy. [5][6][7][8] This emphasises the need to ensure that individuals with diabetes receive adequate screening and are oVered timely treatment. Recommendations in Australia are for people with diabetes to have a dilated pupil examination at least every 2 years. People with signs of diabetic retinopathy, if not already seeing an ophthalmologist, should be referred to an ophthalmologist for further management. Prompt and eVective delivery of ophthalmic care to people with diabetes not only reduces personal suVering caused by blindness but also yields substantial cost savings. Previous studies have shown that the costs of providing preventative eye care are much less than the costs involved with providing support for a subsequent disability. [10][11][12] Studies from the United States have shown that current recommendations for periodic screening for diabetic retinopathy are not well adhered to. [13][14][15] However, little research has been done in Australia to determine whether people with diabetes receive regular eye examinations in accordance with recommendations. Our recent study showed that most general Br J Ophthalmol 1998;82:410-414 410

Epidemiological and ophthalmological findings in diabetic patients examined in a general hospital

“…These findings reproduce the conditions of SUS patients in our region (6,7) and are in agreement with most studies conducted in different locations (5)(6)(7)(8)(9)(10)(11)(12)(13)(24)(25)(26)(27)(28)(29) , which show that longer disease duration and greater difficulty controlling the disease (requiring insulin use) are associated with more severe ocular manifestations.…”

“…Most diabetic patients, with rare exceptions (4) , do not undergo preventive ophthalmic examination with the recommended frequency and they ignore the consequences of the disease and the importance of prevention (5)(6)(7)(8)(9)(10)(11)(12)(13) . The most efficient method for evaluating the population utilises non-mydriatic cameras and specialised image-processing centres (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) .…”

Evaluation of Diabetic Patient Care Quality in Primary Care

“…The rate of diabetic patients examined by ophthalmologists were two thirds, 61% and 42% in three different studies and examination by a neurologist was reported as 7% (15)(16)(17). In our study, examination rate by an ophthalmologist was 64.7% and neurologic examination had been performed in 25.7%.…”

Perfil epidemiológico e nível de conhecimento de pacientes diabéticos sobre diabetes e retinopatia diabética

“…Apesar de já existirem evidências de que a educação de pacientes diabéticos e seus parentes constitui um ponto fundamental tanto para encorajar rastreamentos mais regulares para RD quanto na prevenção e tratamento da RD (14,(19)(20)(21)(22)(23) , a maioria dos pacientes na nossa amostra relata que nunca havia recebido alguma informação ou palestra sobre diabetes de algum profissional de saúde, bem como não haviam recebido algum tipo de material informativo sobre DM. Uma grande parte da nossa amostra também nunca havia participado de programas de educação sobre DM.…”