Practice patterns of diabetic retinopathy referral among doctors in a tertiary hospital.

ABSTRACT

Background: There were 31.7 million diabetics in India in year 2000 with a projection to reach 79.4 million by year 2030. We must identify and treat high-risk persons before severe loss of vision occurs. We doctors of all specialities have to strive together to create awareness of the importance of routine eye evaluation for all diabetics as this blindness is largely irreversible once set in. Visual impairment as a result of Diabetic Retinopathy (DR) has a significant impact on patients’ quality of life. In communities in which intensive retinopathy screening programmes have been implemented, rates of vision loss have decreased. There is a need to increase the awareness among doctors of all specialities on the importance of retinal examination by ophthalmologists even in well controlled diabetics. Aims & Objective: A survey to assess the practice patterns among doctors about diabetic retinopathy referral, its complications, treatment modalities and the knowledge about timing of referral to ophthalmologists. Material and Methods: Questionnaires consisting of 16 questions pertaining to general awareness, clinical manifestations, complications and treatment was given to doctors in two sections A and B. Answers were analysed and tabulated. Results: 36 doctors of various specialities participated in the survey. 19.4% of doctors felt there was no need to refer all diabetics routinely for fundus examination. 80.6% (29 of 36) of doctors were regularly referring all diabetics to ophthalmologist, where as 19% did not. 86.1% of the participants felt there was no need to worry about retinopathy if blood sugar levels were controlled. Amongst the participants 75% were well aware of DR, its presentation, complications and 88.9% about its treatment. Conclusion: Diabetic retinopathy still is not well understood among general doctors and non-ophthalmologists. It is therefore advisable to educate consultants about the severity of the problem and need for early referral to prevent complications. General Practitioners can be educated about the timing to seek expert opinion for treatment.