Prevalence of diabetic retinopathy in a group of diabetic clinic patients at National District Hospital, Bloemfontein
Cairncross, J. P.
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Introduction: Uncontrolled diabetes may lead to multi-organ disease in patients. In South Africa diabetic retinopathy accounts for 8% of cases of blindness. It is the third most common cause for blindness after cataract and glaucoma. Primary health care interventions with the provision of eye care services play an important role in preventing these eye complications in diabetic patients. Eye complications can be identified and treated as part of routine diabetic care. Aim: The aim of this study was to determine the prevalence of eye pathology in a group of diabetic clinic patients at National District Hospital (NDH) by using non-mydriatic digital fundus photography as a screening tool. Methodology: Two hundred and three diabetic patients participated in the study. A short interview with patients was conducted to obtain a diabetic and previous retinopathy screening history. Visual acuity was assessed, intra-ocular pressure was measured and non-mydriatic digital fundus photography was used as the screening method. Results: Over the last year 46 (23.0%) of the 203 patients included in this study complained to their health care practitioner about their vision. 170 (85.0%) patients’ vision problems were not investigate by the doctor, 191 (95.5%) did not have their vision checked with a Snellen chart, and 164 (82.0%) were not examined with an ophthalmoscope. Since their diagnosis of diabetes, only 31 (15.5%) of patients were referred to an ophthalmologist. Only 136 (68.0%) of patients knew that diabetes could exacerbate their vision. Of the 203 patients screened, 97 (48.0%) were referred to ophthalmic specialists and 87 (42.9%) to optometrists. Of those referred to ophthalmologists, 37 (18.2%) had suspected glaucoma, 30 (14.8%) had cataracts and 22 (10.8%) were referred for diabetic retinopathy. Conclusion: This study confirms that glaucoma, cataracts and diabetic retinopathy are prevalent eye conditions amongst diabetic patients presenting for follow-up examinations at NDH. Just less than a half needed referral. Offering eye screening at primary healthcare level leads to early detection and early referral for sight-saving treatment.