scholarly journals Feasibility, safety and clinical efficiency of optometric service pathways at primary and tertiary care level in Ampang, Malaysia

2019 ◽  
Vol 16 (3) ◽  
pp. 193-210
Author(s):  
Duratul Ain Hussin ◽  
Peter Hendicott ◽  
Andrew Carkeet ◽  
Philip Baker ◽  
Ai-Hong Chen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Health Screening ◽  
Health Clinic ◽  
Health Examination ◽  
Care Providers ◽  
Diabetic Retinopathy Screening ◽  
Clinical Efficiency ◽  
Ocular Health ◽  
Retinopathy Screening

Aim: To evaluate feasibility, safety, and clinical efficiency of optometrists in conducting diabetic retinopathy screening and ocular health screening. Methods: This was a prospective observational trial study of newly developed optometric service pathways established at a community health clinic for diabetic retinopathy screening and a hospital ophthalmology clinic for ocular health screening. The study was carried out to assess the feasibility and safety of eye examinations conducted by optometrists. Patients were examined by optometrists using a standard eye examination at both clinics and re-examined by ophthalmologists as the reference standard. Optometrists recorded diagnoses of ocular conditions and classified referral urgency for each patient and these were compared with the diagnoses made by ophthalmologists, who were masked to the optometrists’ findings. Results: There was a high concordance of 87.0% (95% CI 80.4%-93.6%) for the diagnoses between the optometrists and ophthalmologists. Of 26 patients considered by the optometrists to need ophthalmology referral, 23 were agreed as such by the ophthalmologists, giving good agreement, κ = 0.76 (95% CI 0.53 -0.94) between the optometrists and ophthalmologists on referral classification. Agreement by the ophthalmologists for referral urgency classifications (very urgent/urgent or non-urgent) was very good (κ = 0.85, 95%CI 0.62-1.00). Conclusions: Ocular health examination by optometrists using optometric-eyecare pathways is feasible and safe. Optometrists showed strong agreement with  ophthalmologists when diagnosing patients who had a range of ocular conditions. Optometrists were also able to triage referrals and their urgency accurately, suggesting that they could play an extensive role as primary eye care providers, thus reducing unnecessary referrals to ophthalmology clinics.

scholarly journals Five regions, five retinopathy screening programmes: a systematic review of how Portugal addresses the challenge

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto
Keyword(s):  
Diabetic Retinopathy ◽  
Web Sites ◽  
National Health System ◽  
Health Department ◽  
Population Based ◽  
Care Providers ◽  
Levels Of Care ◽  
Diabetic Retinopathy Screening ◽  
Relevant Role ◽  
Retinopathy Screening

Abstract Background The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes, and difficulties. However, factors such as the existence of regional programmes, specificities of each country’s health systems, organisational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organisations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed. Results Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading, and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening. Conclusion Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics. Trial registration PROSPERO registration ID CRD42020200115.

scholarly journals Utilization of diabetic retinopathy screening among diabetic patients at a tertiary care hospital in Kerala, India

2021 ◽  
Vol 8 (10) ◽  
pp. 4938
Author(s):  
Sona Sabitha Kumar ◽  
Lathika Vasu Kamaladevi ◽  
Sruthi Mankara Valsan
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Adult Population ◽  
Tertiary Care ◽  
Health Concern ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Screening Programs ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

Background: Diabetes is a major public health concern that affects nearly 463 million (9.3%) of global adult population. Diabetic retinopathy, which affects around 35% of all diabetic patients, is the fifth leading cause of preventable global blindness. This study was done to determine the status of diabetic retinopathy screening and the factors that influence its uptake among diabetic patients attending a tertiary care setting in Kerala, India.Methods: 200 patients with diabetes mellitus on physician care were enrolled for a questionnaire-based survey which collected information on patient demographics, education, occupation, patient’s awareness of retinopathy, screening, diabetic blindness and their source of such knowledge.Results: 83% were aware that diabetes can result in vision loss. 61% were aware that diabetic blindness is preventable. 42% patients were aware of screening options for retinopathy. The awareness of retinopathy screening was significantly associated (p=0.0001) only with duration of diabetes.Conclusions: Awareness of diabetic retinopathy among diabetic patients in Kerala was sub optimal. Better patient education and use of mass media can increase awareness on diabetes retinopathy screening programs. 

scholarly journals Five Regions, Five Retinopathy Screening Programmes: a Systematic Review of How Portugal Addresses the Challenge

2021 ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel Silva Laureano ◽  
Fernando Buarque Lima Neto
Keyword(s):  
Diabetic Retinopathy ◽  
Web Sites ◽  
National Health System ◽  
Health Department ◽  
Population Based ◽  
Care Providers ◽  
Levels Of Care ◽  
Diabetic Retinopathy Screening ◽  
Non Governmental Organizations ◽  
Retinopathy Screening

Abstract Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods: Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics.Registration: PROSPERO registration ID CRD42020200115.

scholarly journals Five Regions, Five Retinopathy Screening Programmes: A Systematic Review of how Portugal addresses the challenge.

2021 ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto
Keyword(s):  
Diabetic Retinopathy ◽  
Web Sites ◽  
National Health System ◽  
Health Department ◽  
Population Based ◽  
Care Providers ◽  
Levels Of Care ◽  
Diabetic Retinopathy Screening ◽  
Non Governmental Organizations ◽  
Retinopathy Screening

Abstract Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects.Methods: Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics.Registration: PROSPERO registration ID CRD42020200115

scholarly journals Five Regions, Five Retinopathy Screening Programmes: A Systematic Review of the Portuguese Experience

2020 ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto
Keyword(s):  
Diabetic Retinopathy ◽  
Web Sites ◽  
National Health System ◽  
Health Department ◽  
Population Based ◽  
Care Providers ◽  
Levels Of Care ◽  
Diabetic Retinopathy Screening ◽  
Non Governmental Organizations ◽  
Retinopathy Screening

Abstract Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods: Web of Science and PubMed platforms were searched using appropriate key words. Were found 423 articles, 28 of which were selected and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes.Registration PROSPERO registration ID CRD42020200115

scholarly journals EyePACS: An Adaptable Telemedicine System for Diabetic Retinopathy Screening

2009 ◽  
Vol 3 (3) ◽  
pp. 509-516 ◽  
Author(s):  
Jorge Cuadros ◽  
George Bresnick
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Primary Care Providers ◽  
Retinal Images ◽  
Care Providers ◽  
Telemedicine System ◽  
Web Based ◽  
Diabetic Retinopathy Screening ◽  
Standard Clinical Practice ◽  
Retinopathy Screening

Background: Annual retinal screening of patients with diabetes is the standard clinical practice to prevent visual impairment and blindness from diabetic retinopathy. Telemedicine-based diabetic retinopathy screening (DRS) in primary care settings can effectively detect sight-threatening retinopathy and significantly increase compliance with annual retinal exams. EyePACS is a license-free Web-based DRS system designed to simplify the process of image capture, transmission, and review. The system provides a flexible platform for collaboration among clinicians about diabetic retinopathy. Methods: Primary clinic personnel (i.e., nursing, technical, or administrative staff) are trained and certified by the EyePACS program to acquire retinal images from standard digital retinal cameras. Relevant clinical data and eight high-resolution images per patient (two external and six retinal images) are encrypted and transmitted to a secure Internet server, using a standard computer and Web browser. Images are then interpreted by certified EyePACS reviewers or local eye care providers who are certified through the EyePACS Retinopathy Grading System. Reports indicating retinopathy level and referral recommendations are transmitted back to primary care providers through the EyePACS Web site or through interfaces between EyePACS and Health Level 7-compliant electronic medical records or chronic disease registries. Results: The pilot phase of the EyePACS DRS program in California (2005–2006) recorded 3562 encounters. Since 2006, EyePACS has been expanded to over 120 primary care sites throughout California and elsewhere recording over 34,000 DRSs. The overall rate of referral is 8.21% for sight-threatening retinopathy and 7.83% for other conditions (e.g., cataract and glaucoma). Conclusion: The use of license-free Web-based software, standard interfaces, and flexible protocols has allowed primary care providers to adopt retinopathy screening with minimal effort and resources.

Diabetic Retinopathy Screening: A Systematic Review of Qualitative Literature

2021 ◽  
Author(s):  
Oluwaseun Egunsola ◽  
Laura E. Dowsett ◽  
Ruth Diaz ◽  
Michael Brent ◽  
Valeria Rac ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Diabetic Retinopathy Screening ◽  
Qualitative Literature ◽  
Retinopathy Screening

Digital Ophthalmology in the UK – Diabetic Retinopathy Screening and Virtual Glaucoma Clinics in the National Health Service

2020 ◽  
Vol 237 (12) ◽  
pp. 1400-1408
Author(s):  
Heinrich Heimann ◽  
Deborah Broadbent ◽  
Robert Cheeseman
Keyword(s):  
Diabetic Retinopathy ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Daily Practice ◽  
Diabetic Retinopathy Screening ◽  
Technological Advances ◽  
Imaging Results ◽  
The Uk ◽  
Retinopathy Screening

AbstractThe customary doctor and patient interactions are currently undergoing significant changes through technological advances in imaging and data processing and the need for reducing person-to person contacts during the COVID-19 crisis. There is a trend away from face-to-face examinations to virtual assessments and decision making. Ophthalmology is particularly amenable to such changes, as a high proportion of clinical decisions are based on routine tests and imaging results, which can be assessed remotely. The uptake of digital ophthalmology varies significantly between countries. Due to financial constraints within the National Health Service, specialized ophthalmology units in the UK have been early adopters of digital technology. For more than a decade, patients have been managed remotely in the diabetic retinopathy screening service and virtual glaucoma clinics. We describe the day-to-day running of such services and the doctor and patient experiences with digital ophthalmology in daily practice.

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