Diabetes Eye Screenings: Why They Are Important and Challenging

This content originally appeared on Diatribe. It was reissued with permission.

Renza Scibilia and Chris ‘Grumpy Pumper’ Aldred

What causes diabetes-related retinopathy?

Diabetes-related retinopathy occurs when long-standing hyperglycemia levels cause damage to the blood vessels of the eye. This damage will cause your body more Blood vessels – However, these new containers are fragile and easily damaged, which can cause eye bleeding or scarring that worsens vision. Fortunately, medications are available that can help improve symptoms. For more information about diabetes-related retinopathy, see here.

A1c is not the only place in developing diabetes-related eye conditions. As seen in recent research, time within range also plays a role. Diatribe will update readers on this in the coming months. Blood pressure also plays an important role in risk, allowing rapid fluctuations in glucose levels. It is important to know and share family history when discussing the eyes at an appointment screening, as family history of eye conditions such as glaucoma and age-related macular degeneration (AMD) can increase the risk of diabetes-related eye problems.

The importance of eye screening

In an interview with Dr. Ivan Suñer of Tampa Memorial Hospital with Diatribe’s past eye doctor (Eye Doctor), we learned that people with retinopathy often lack prominent symptoms until they are at a higher risk of losing their vision. Early detection of diabetes-related retinopathy is important to prevent vision loss. Therefore, his number one advice was to meet with the doctor regularly for eye screening. The American Diabetes Association (ADA) recommends that diabetics undergo a comprehensive eye examination every two years if the patient does not have evidence of retinopathy. For people with retinopathy, the ADA recommends having an eye test every year.

Given the importance of eye screening, Renza and the grumpy – within a few days of each other – both recently tweeted about upcoming eye screening checks. (Lenza visits private ophthalmologists every year, as suggested by Australian guidelines. Gramps is screened every 3-4 months to monitor injuries to left eye.)

We (Lenza and Grumpy) are fortunate to live in a country where we have a national visibility screening program for diabetics. (The Australian programme started this year. The UK programme has been around for years.)

In Australia, KeepSight acts as a “recall and reminder” system. Diabetics will register for the program and will be prompted to make an appointment. The frequency of these reminders is adjusted individually and determined by the frequency at which screening checks are required.

In the UK, the Diabetes Gaze Screening Program (Name Time and #LanguageMatters Attention Time!) is overseen by the National Health Service (NHS). Screening appointments are made for people with diabetes and a follow-up letter will be sent along with the results.

The national screening program works because it offers a coordinated, consistent approach that can reach many people. In an ideal world, they capture all people living with diabetes, screening occurs at the right time, eye changes are identified early and appropriate treatment begins immediately.

When properly implemented, the results of the screening program are astounding. Before the UK programme was established, diabetes-related eye conditions were the main cause of preventable blindness in the UK. That’s not the case anymore.

Eye screening challenges

People with diabetes don’t look forward to eye screening. And many of us look for excuses to postpone or appoint screening appointments. There are several reasons for this.

It may be one of the most invasive checks on the screening list, but it can be one of the most destructive. If pupil dilation drops are required, the rest of the day is often amortized. Even with blurry vision, we often feel tired or headaches from the bright light and tension in the eyes caused by the drops.

In addition to organizing work, school holidays and schools for ourselves, we may need to involve friends and family to take us to appointments. All of this makes adjustments to our appointment difficult and provides reasons to postpone or cancel.

However, logistics is just one reason why we may decide to postpone our appointment. Many of us are concerned about the results of screening checks. Diabetes-related complications are often presented to us in such a horrifying and threatening manner that we fear organizing and attending appointments. (Lenza wrote this article recently, “Why does fear tactics not work with diabetes?” and for Diatrib about how he couldn’t face the idea of ​​screening for diabetes because referrals to diabetes related complications scared her when he was diagnosed with diabetes.)

And we have missed one or two bookings or never been screened before, and we are worried that we were “told” when we finally gather the courage to attend.

What works and how can you do it well?

• Creating a process that allows for the process of actually making the eyes of diabetes as simple and smooth as possible will always mean more intake. Rather than expecting people to travel long distances, bringing screening to people reduce the important barriers to keeping screening checks up to date. There are various initiatives working to make screening checks more convenient.
• In some regions, pharmacies are used to provide initial screening checks (using retinal scan cameras), and the necessary follow-up is done by specialized ophthalmology professionals. This works well as this means that the initial screening check (recovering changes) is done somewhere convenient and familiar, without the need for drip expansion. Hopefully this will reduce some of the tension people may feel about going to the clinic or hospital.
• The tuned reminder system is amazing! Anything that helps to alleviate the weight of “diabetic administration” is welcome to assist with the daily tasks that diabetes requires.
• Counseling during the visit is also helpful for some!

Having any type of diabetes-related complication screening is not just the process of participating in and completing the screening. The idea and planning of appointment can be painful for people, especially for those who have had complications in a horrible or threatening manner. Providing counseling before and after screening is a great idea to help you deal with some of these anxiety and provides practical tips for people to deal with.

Screening checks are part of the process of managing diabetes-related complications

We encourage medical professionals to realize how difficult it is for someone to simply show up in a screening appointment and praise them for doing so. A little understanding can come a very long way!

As always, peer support is extremely beneficial. Whether people share stories about eye screening checks about how people navigate anxiety and tension, how they dealt with the diagnosis, talking to others walking along similar paths can be useful and can help reduce the isolation that many people feel.

And finally, most people with diabetes know the importance of regular complication screening, and their early detection and treatment may have better results. (In the case of Grumps, this early detection means that the problem has not progressed for several years and treatment is not needed to date. But that isn’t enough. You should follow messages and campaigns that emphasize the importance of screening with advice on how to make the process easier and more comfortable for people with diabetes. Humanizing the screening experience, giving results, and following up are all important parts of the story.