Literature DB >> 35647961

Commentary: Diabetes eye screening in India.

Raminder Singh1.   

Abstract

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Year:  2022        PMID: 35647961      PMCID: PMC9359253          DOI: 10.4103/ijo.IJO_2935_21

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   2.969


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Based on my experience of the NHS Diabetic Eye Screening Programme in United Kingdom, I have a few words of wisdom, words that we all already know: Prevention is better than cure. As a consensus, we all probably agree that the importance of screening for diabetic retinopathy (DR) cannot be over- or under-stressed. In this article, we can clearly see that the divide between the urban and rural Indian populations is narrowing clinically. We also know that the availability of equipment and manpower for screening is probably widening between rural and urban India. I quote from this article: “Pooled estimates indicate a narrow difference in DR prevalence among people with diabetes in rural and urban India. The fast urbanization and increasing diabetes prevalence in rural areas underscore the need for providing equitable eye care at the bottom of the health pyramid.”[1] It is a social responsibility of the ophthalmologist or optician or optometrist community in India to provide the service of diabetes eye screening at an affordable cost to the population in every corner of India, so that the remote areas are not left out. Few important points that we need to ponder upon. The availability of community ophthalmology services, especially in North India, needs to be worked upon. It is very important to tackle cataract blindness, but it is also important to screen for other eye conditions which can lead to preventable blindness, especially in the working age group. Thus, a framework for screening for DR and glaucoma needs to be planned by health services. Training of health professionals at remote clinics will be helpful. The National Programme for Control of Blindness can be optimized by using information from such meta-analyses. For a screening program to be viable, it should be cost effective and should make a statistically significant change in society as a whole. In a broader sense, the DR screening program should be able to differentiate between non-proliferative and proliferative changes. It may be difficult to assess for diabetic macular edema (DME) with 2D photographs or direct ophthalmoscopy. There is always a scope to understand grading systems for DR like the NHS Diabetic Eye Screening Programme of the United Kingdom. We need to plan a nationally agreed pathway for patients graded as non-proliferative diabetic retinopathy (NPDR) and (proliferative diabetic retinopathy) PDR. How do we deal with patients identified as such? Just having a screening program may not be a good idea in itself. Due to its cost, the treatment for DME can be out of reach for many. Thus, we need a wider financial planning in higher government circles dealing with health economics. The importance of health education of the masses, both of the urban and rural Indian populations, again is of paramount importance as many may not understand the real threat to vision posed by the progression of diabetic retinopathy, and hence the importance of diabetic eye screening. That brings us to another pearl of wisdom we all already know: Nip the problem in bud.
  1 in total

Review 1.  Prevalence of diabetic retinopathy in urban and rural India: A systematic review and meta-analysis.

Authors:  Anand Singh Brar; Jyotiranjan Sahoo; Umesh Chandra Behera; Jost B Jonas; Sobha Sivaprasad; Taraprasad Das
Journal:  Indian J Ophthalmol       Date:  2022-06       Impact factor: 2.969

  1 in total

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