Screening history of those with severe visual impairment due to diabetic retinopathy

Purpose To examine screening activity prior to blind registration due to diabetic retinopathy (DR) in NI. To identify any grading misclassifications and risk factors for blindness in those screened. Methods Details on all registered blind due to diabetic retinopathy were obtained from the statutory register (SOSCARE). Demographic data (surname, date of birth and sex) were used in any combination to ascertain previous screening within the evolving NI Diabetic Retinopathy Screening Programme. Screening history and clinical chart review formulated the history prior to registration. Results The prevalence of diabetic blindness amongst the diabetic population was 0.34%.(171 people) 56% were female and the average age was 65.6(SD 15.6). Diabetic maculopathy was cited as the commonest cause ( 83%) with proliferative disease in 17%. 84% had never been screened and were under the care of an eye clinic. 27 people ( 16%) had been screened within the previous 4 years. 22 of these had been discharged from eye clinics post registration. 5 had never attended an eye clinic. 4 of these showed maculopathy on screening and were referred to an ophthalmologist. One person aged 31, diabetic for 20 years, was screened 2 years prior to registration due to PDR. The screening result was given as no retinopathy in either eye. The digital images were reassessed and no change in grade made. Detailed scrutiny of clinical notes revealed a recent history of severe anorexia with insulin used to control weight. Conclusion Timely referral from screening is required for optimal management, but it must be recognised that vision cannot be maintained in all cases. Risk factor stratification for earlier screening in exceptional circumstances may be wise.Commercial interest