Why is a Diabetic Eye Test Important to Primary Physicians?
Diabetic Retinopathy (DR) is the leading cause of preventable blindness for people 20 to 65 years of age in the United States. 29.1 million people or 9.3% of the population have diabetes, according to the Center for Disease Control and Prevention (CDC).
The American Academy of Ophthalmology recommends that all patients with diabetes or pre-diabetes receive an annual retinal eye exam or diabetic eye exam for diabetic retinopathy (DR). However, historically only 40-50% of the diabetic patient population receives this important annual diabetic eye test.
Why should primary care providers (PCP) care about a Diabetic Eye Test?
While blindness from diabetes is irreversible, the good news is that vision loss from diabetes is almost completely preventable, especially if diabetic patients receive an annual diabetic eye exam. Early detection and treatment of Diabetic Retinopathy is key and reduces the risk of severe vision loss by 90%. However, according to the prominent retinal surgeon and IRIS founder, Dr. Sunil Gupta, a high percentage of patients with diabetes never get screened or receive an annual diabetic eye test.
“Retina specialists now utilize advanced therapies that virtually guarantee that patients do not have to lose their vision if detected early,” said Dr. Gupta. “We have spent over a decade developing effective pharmacological therapies that have changed the realities for diabetic patients with indications of eye disease.”
While the comprehensive annual dilated eye exam is still considered a standard of care for patients with diabetes, reality shows a majority of patients do not get an retinal scan for diabetes annually. By performing a diabetic eye test as a routine annual diagnostic in primary care, providers identify more diseases earlier in patients otherwise going untreated for pathology. Eye care providers and primary care providers gain access to these at-risk patients early and can reduce the risk of vision loss and improve outcomes for these patients.
According to the CDC’s 2014 National Diabetes Statistics Report, “Diabetes can be treated and managed by healthful eating, regular physical activity, and medications to lower blood glucose levels. Another critical part of diabetes management is reducing cardiovascular disease risk factors, such as high blood pressure, high lipid levels, and tobacco use. Patient education and self-care practices also are important aspects of disease management that help people with diabetes stay healthy.” With having the data from the annual eye exam documented as part of the patient’s medical record, primary care can also contribute to improved outcomes in vision and overall health and management of this patient population.
The annual diabetic eye exam for diabetic eye diseases, such as diabetic retinopathy, is an important tool to monitor the overall health of diabetic populations, especially as health providers look to improve their HEDIS compliance rates. With recent advances in telemedical screening technology, these quick and simple eye tests can be administered in the primary care setting, driving up screening rates and reducing the number of patients with vision loss.
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Diabetic Eye Exam FAQs
- What is the difference between a regular eye exam and a diabetic eye exam?
A regular or comprehensive eye exam is typically administered by a licensed Optometrist or Ophthalmologist. This exam includes multiple assessments of the health of the eye and vision. During this exam, a patient can expect the following steps:
- Visual acuity test to determine vision
- The measure of your eye pressure
- Evaluation of eye health
A diabetic eye exam focuses primarily on the small blood vessels of your retina to determine if the patient may be showing signs of diabetic retinopathy.
- How often should a diabetic have an eye test?
Generally, this should be an annual event for someone with Type 1 or 2 diabetes. According to the American Academy of Ophthalmology website (AAO):
“People with type 1 diabetes should have annual screenings for diabetic retinopathy beginning 5 years after the onset of their disease, whereas those with type 2 diabetes should have a prompt screening at the time of diagnosis and at least yearly screenings thereafter.”
Certainly, if a patient has poor glucose control or high blood pressure a provider may seek to increase the frequency of these exams.
- How is diabetic retinopathy diagnosed?
Diabetic retinopathy is diagnosed through a retinal scan for diabetes conducted by an eye care professional or by any provider with access to a fundus camera. A fundus camera captures images of the back of the retina as viewed through the pupil. These images are then examined by an eye care professional to determine the existence or extent of DR.
- What is a diabetic eye exam?
A diabetic eye exam is strongly encouraged for anyone with diabetes. This exam allows your provider to look for changes in the blood vessels of the retina that may indicate diabetic retinopathy. Your doctor can catch problems early if you get regular eye exams. The doctor may take photos of the back of your eye to get a more detailed exam. This exam is called a digital retinal scan (or imaging). A special camera is used to take photos of your retina without dilating your eyes. The doctor then views the photos and lets you know if you need more tests or treatment. The early stages of diabetic retinopathy don’t cause changes in vision, and you won’t have symptoms. Only an eye exam can detect the problem so actionable steps can be taken to prevent the eye damage from getting worse.
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