Executive Summary

Global prevalence of diabetes mellitus and diabetic retinopathy Diabetes mellitus currently affects more than 170 million persons worldwide and will affect an estimated 366 million by 2030, with the most rapid growth in low and middle-income countries, among populations of working age. More than 75 of patients who have had diabetes mellitus for more than 20 years will have some form of diabetic retinopathy. Diabetic retinopathy is a microvascular complication of both type 1 and type 2 diabetes...

Nonophthalmic health professionals

PR I NC I PLES FOR ORGAN I Z I NG EYE HEALTH SYSTEM FOR THE CARE OF D I ABETI C RETI NOPATHY having to see yet another doctor (an ophthalmologist) presents an additional burden (59). Thus, being able to see just one doctor for comprehensive diabetes care enhances the continuity of care and thus the ability to receive higher quality care. General practitioners are usually best paced to situate the rsk for vision loss for each patent as part of the overall care strategy for diabetes, as the known...

A uniform classification system should be adopted

It is recommended that the International Clinical Classification of Diabetic Retinopathy (See Annex 3.), which provides a sound scientific bass for a uniform grading system, be used as an acceptable minimum standard for assessing diabetic retinopathy in programmes for prevention of blindness. This system provides a simplified but sound scientific basis for uniform grading by general ophthalmologists who have a basic understanding of diabetic retinopathy and skills in evaluating the retina. It...

World Health Organization 2006

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Followup physical examination

best-corrected visual acuity A I measurement of intraocular pressure A II (aplanation tonometry) gonioscopy when indicated (for neovascularzation of the ms or increased intraocular pressure) A II slit-lamp biomicroscopy with ms examination A I stereo examination with biomicroscopy of the posterior pole A l examination of the perpheral retina, best performed with indirect ophthalmoscopy or with slit-lamp biomicroscopy, combined with a contact lens A lll Discuss results of examination and...

Appropriate followup intervals

Once diabetes mellitus has been diagnosed and patients have had an initial eye assessment, of any kind, they must continue eye care. As there is no cure for diabetes mellitus, prevention of vision loss requires regular examinations. Nevertheless, there are significant problems in ensurng appropriate follow-up. The shortfall in efforts to ensure approprate follow-up is illustrated by studies showing that only 68-85 of patients referred for treatment start the treatment, and only 85 who start...

Technical issues in the use of standard photographic images

In view of the interest in photographic systems, much work has been devoted to specific technical issues (72,75), including the number of photographs needed the fields to be used if the full seven-field set is not used whether photographs should be taken through dilated pupils and who should interpret the photographs. In 2004, the American Academy of Ophthalmology concluded that, in the United States, single-field photography is adequate for screening for the purpose of detecting diabetic...

Education about eye health among patients with diabetes should be patientcentred

Public awareness about diabetes mellitus and diabetic retinopathy is lacking in all societies. It is recommended that health education about these conditions be intensified, and education material and campaigns be oriented to address issues from the patient perspective and not solely that of the provider. Providers and organizations should therefore reassess their educational campaigns and change them into marketing campaigns. Health education must involve local populations and health care...

Principles In Eye Care For Patients With Diabetes

Diabetic retinopathy remains the leading cause of new-onset blindness in populations of working age, even in the United States (21) and other industralized countres. Despite clearly defined clinical standards for evaluating and treating diabetic retinopathy cost-effectively, for a varety of reasons (see below), effective treatments such as laser surgery are underused. It has been estimated that 50 of adults with diabetes mellitus in the United States do not receive the recommended annual eye...

Agenda purpose and expected outcome

The global burden of diabetes mellitus and complications Current burden and trends Diagnosis and classification of complications of diabetes mellitus Clinical practice guidelines for diabetes and its complications Eye care deficiencies contrbuting to blindness from diabetic retinopathy Improving integration of eye care within diabetes management Patient and pubic education and awareness Core content of patient and pubic diabetic retinopathy education Materais Disease and its complications...

References

Diabetes care and research in Europe the Saint-Vincent Declaration. Diabetic medicine 7 360-364 1990 2. Roglic G et al. The burden of mortality attributable to diabetes realistic estimates for the year 2000. Diabetes Care, 2005, 28 2130-2135. 3. Beaglehole R, Epping-Jordan J. Preventing chronic diseases, a vital investment. Geneva, World Health Organization, 2005. 4. Wild S et al Global prevalence of diabetes estimates for the year 2000 and projections for 2030. Diabetes Care, 2004, 27...