Screening for diabetic retinopathy by non-ophthalmologists: an effective public health tool


Verma, L; Prakash, G; Tewari, HK; Gupta, SK; Murthy, GVS; Sharma, N; (2003) Screening for diabetic retinopathy by non-ophthalmologists: an effective public health tool. Acta ophthalmologica Scandinavica, 81 (4). pp. 373-7. ISSN 1395-3907 DOI: https://doi.org/10.1034/j.1600-0420.2003.00004.x

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Abstract

PURPOSE: To investigate and report the reliability of detection and grading of diabetic retinopathy by direct ophthalmoscopy through a dilated pupil by general physicians (non-ophthalmologists) and optometrists who have undergone a short period of training. METHODS: A total of 400 eyes of 200 diabetes patients were examined by two non-ophthalmologists. Their observations were compared with an ophthalmologist's diagnoses for the same patients. RESULTS: The diagnoses made by the general physician (kappa = 0.8381, SE = 0.041) and the optometrist (kappa = 0.7186, SE = 0.051) showed good rates of agreement with the ophthalmologist's diagnoses. CONCLUSIONS: The provision of appropriate screening protocols and follow-up parameters can enable primary care physicians and support personnel to reliably screen individuals for retinopathy in diabetes. This will reduce the workload of tertiary hospitals, and provide optimal services to the huge majority of the Indian population that has limited access to eye care services.

Item Type: Article
Keywords: Adult, Aged, Aged, 80 and over, Blindness, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Family Practice, Female, Humans, India, Male, Middle Aged, Ophthalmoscopy, Optometry, Public Health Practice, Reproducibility of Results, Visually Impaired Persons, Adult, Aged, Aged, 80 and over, Blindness, prevention & control, Diabetes Mellitus, Type 1, complications, Diabetes Mellitus, Type 2, complications, Diabetic Retinopathy, classification, diagnosis, Family Practice, standards, Female, Humans, India, Male, Middle Aged, Ophthalmoscopy, Optometry, standards, Public Health Practice, standards, Reproducibility of Results, Visually Impaired Persons
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 12859264
Web of Science ID: 184109100011
URI: http://researchonline.lshtm.ac.uk/id/eprint/8791

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