Determinants of previous dilated eye examination among type II diabetics in Southwestern Nigeria.

PURPOSE: To assess the prevalence and factors influencing previous dilated eye examination in screening for retinopathy among type II diabetics.
METHODOLOGY: Cross-sectional study of type II diabetic patients receiving treatment at a tertiary hospital in southwestern Nigeria was conducted with information on gender, age, duration of diabetes, current medication and previous dilated eye examination recorded. Eye examination included visual acuity, pen torch examination, applanation tonometry and direct ophthalmoscopy of the dilated eye in a dark room. Visual acuity was presented as classified by WHO while data was analyzed using SPSS version 11 and statistical significance inferred at P<0.05.
RESULTS: Eighty three type II diabetics with mean age 57.5+/-10.8 years and mean duration of diabetes of 6.6 years were studied. Visual impairment (<6/18 in the better eye) and blindness (<3/60 in the better eye) were recorded in 3.6% and 12% of the patients respectively while diabetic retinopathy was present in 21.6%. Only 24 [28.9%] diabetics had previous dilated eye examination; absence of eye symptoms [50.8%] and lack of referral [45.8%] were the main barriers to having previous dilated eye examination. Previous dilated eye examination was significantly influenced by the presence of visual impairment/blindness [P=0.002], longer duration diabetes mellitus [P=0.006], current insulin treatment [P=0.040] and presence of non-diabetic vision threatening eye diseases [P=0.016].
CONCLUSION: Dilated eye examination rate is low; inadequate knowledge about diabetic retinopathy as well as low referral rates is contributory. Massive health education on diabetic retinopathy as well as development of sustainable retinopathy screening protocol would be helpful. Copyright 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.