OBJECTIVE: To determine the prevalence of diabetic retinopathy among patients with non-insulin dependent diabetes (NIDDM) attending a Sri Lankan diabetes clinic and assess the skills of non-ophthalmologist in screening for retinal disease. RESEARCH DESIGN AND METHOD: One thousand and three consecutive diabetic patients were screened for diabetic eye disease using a standardised technique based on the WHO Multinational Study. RESULTS: 31.3% (95% confidence intervals 28.0% to 31.6%) had retinopathy, 23% (95% confidence intervals 21% to 25%) had cataract and 20% (95% confidence intervals 17% to 23%) had previously undetected refraction errors. 4.1% (95% confidence intervals 2.1% to 6.0%) of patients were blind due to advanced retinal disease while 6.2% (95% confidence intervals 5.0% to 7.2%) were blind as a result of cataract. General physicians had a 90.6% sensitivity and 100% specificity in screening for retinal disease. CONCLUSIONS: Retinopathy accounts for significant visual handicap. Untreated cataract is more commonly associated with blindness. Undiagnosed errors of refraction account for significant visual handicap in Sri Lankan diabetic patients. Physicians trained in techniques of retinal screening can correctly assess diabetic retinal changes in a high proportion of patients.
OBJECTIVE: To determine the prevalence of diabetic retinopathy among patients with non-insulin dependent diabetes (NIDDM) attending a SriLankan diabetes clinic and assess the skills of non-ophthalmologist in screening for retinal disease. RESEARCH DESIGN AND METHOD: One thousand and three consecutive diabeticpatients were screened for diabetic eye disease using a standardised technique based on the WHO Multinational Study. RESULTS: 31.3% (95% confidence intervals 28.0% to 31.6%) had retinopathy, 23% (95% confidence intervals 21% to 25%) had cataract and 20% (95% confidence intervals 17% to 23%) had previously undetected refraction errors. 4.1% (95% confidence intervals 2.1% to 6.0%) of patients were blind due to advanced retinal disease while 6.2% (95% confidence intervals 5.0% to 7.2%) were blind as a result of cataract. General physicians had a 90.6% sensitivity and 100% specificity in screening for retinal disease. CONCLUSIONS:Retinopathy accounts for significant visual handicap. Untreated cataract is more commonly associated with blindness. Undiagnosed errors of refraction account for significant visual handicap in Sri Lankan diabeticpatients. Physicians trained in techniques of retinal screening can correctly assess diabetic retinal changes in a high proportion of patients.