Results of a specialised diabetes retinopathy screening initiative in Cork will be published by Minister Kathleen Lynch, TD, Minister of State, Department of Health today, 27th January 2012.
Diabetic retinopathy is a serious complication of Diabetes which if left untreated can lead to blindness. There are approximately 25,000 people in the Cork and Kerry region who have diabetes. It is estimated that approximately 10% of this group will be diagnosed with diabetic eye disease throughout their life. Blindness due to diabetic retinopathy accounted for more than 10% of new registrations amongst working adults (16-64 years) in 2003 which indicates the economic and social impact of this disease. However, retinopathy is a treatable complication if there is early detection through screening and timely treatment in the event of the development of diabetic eye disease.
The evaluation was carried out by the Department of Epidemiology & Public Health, University College Cork on behalf of the HSE South in consultation with Diabetes in General Practice and Association of Optometrists Ireland to evaluate the screening initiative which was set up in Cork in 2011. The report highlighted that this initiative demonstrated it was possible to address some of the current screening deficit using existing resources in the community. The report also emphasised that the implementation of the proposed National Diabetic Retinopathy Screening Service is the optimum way to detect and treat diabetic eye disease into the future.
In 2009, retinopathy screening was prioritised by the National Diabetes Programme, which was established under the governance of Dr. Barry White, National Director of the HSE’s Quality and Clinical Care Directorate. One of the key objectives of the national programme was the establishment of a National Diabetic Retinopathy Screening Service. The national screening service is scheduled to be available nationwide to patients with diabetes in late 2012 and is currently undergoing a national commissioning process.
In the intervening period, the local Diabetes Services Implementation Group (DSIG) in Cork and Kerry proposed a retinopathy screening initiative as an interim arrangement in advance of the national screening programme being available in HSE South. The local DSIG has been operational since September 2009, planning services and working towards the objectives of the National Programme in the area. The group also engaged with local Optometry and Ophthalmology services to provide accessible quality assured screening for patients. Participants in this initiative included 30 GP practices, 15 Optometry practices, 2 Community Ophthalmologists with access to more than 3,500 patients with diabetes.
A total of 3,598 patients with diabetes were invited for screening by their GPs – GPs were members of the Diabetes in General Practice (DiGP) group – between 1st February and 20th June 2011. A total of 1,763 people had attended for screening (49%) by the 21st September 2011. From this:
· Sight-threatening retinopathy was detected in 11 patients.
· One of which required emergency/same day referral to the ophthalmology specialist.
· Six patients with sight-threatening retinopathy were not attending ophthalmology specialists.
Prior to this initiative, the majority of retinopathy screening in Cork had traditionally taken place at Cork University Hospital’s Ophthalmology Department. This community-based initiative maximised the use of existing community based resources (Optometry/Ophthalmology clinics) to ensure easy access for patients and to allow specialist services to focus on treating confirmed eye disease.
Welcoming the publication of the report, Gabrielle O’ Keeffe, General Manager, HSE Cork and Chairperson of the Retinopathy Sub Group said, “The screening programme aims to reduce the serious complications associated with diabetic eye disease. The screening process itself involves taking a digital photograph of the eye with a specialised camera which is then uploaded onto a computer system and assessed by qualified Graders. Locally based Opticians and Opthalmologists facilitated the screening and referral process for those identified with diabetic eye disease.”
Dr. Diarmuid Quinlan, Chair of the HSE South Diabetes Strategy Implementation Group said, “Patients greatly valued having access to free screening which was also locally accessible. The evaluation has led to a number of recommendations which will help inform the development of the national retinopathy screening programme. Diabetic retinopathy can develop and progress without symptoms becoming obvious until significant damage has occurred. The HSE wishes to make the public aware of the risk of blindness from diabetic eye disease and the benefits of annual screening in early detection and treatment”.
Mr. Pat Healy, Regional Director of Operations, HSE South said, “This initiative was successfully delivered through the expertise, innovation, goodwill and collaborative working of a range of individuals and organisations. This project is a hallmark of the benefits which can be delivered from a dynamic and innovative collaborative between statutory, voluntary, and academic partners”.