When to Screen Diabetic Eyes

Type 2 diabetes patients without retinopathy may safely be screened once every two years

(RxWiki News) Diabetes patients are faced with the possibility of many complications, including eye problems. The American Diabetes Association recommends that people with diabetes get their eyes checked at least once a year.

Researchers have found that it is both safe and cost-effective to screen patients for diabetes-related eye problems every two years instead of yearly. Even patients who have not yet developed eye problems should be tested.

"See an eye care specialist if you have diabetes."

For their study, Daniel Chalk, Ph.D., of the Peninsula College of Medicine and Dentistry, and colleagues set out to compare current screening strategies to a strategy in which diabetes patients without eye problems would be screened once every two years.

"This is not the first study to investigate screening for diabetic retinopathy, but it is the first to focus on the group of type 2 diabetics who have not yet been diagnosed for the condition," says Dr. Chalk.

"Diabetic retinopathy typically develops at a very slow pace, and as a consequence we wanted to identify whether or not there was any merit in reducing the frequency of screening from annually to every two years," he says.

When patients develop eye problems as a result of their diabetes, it is called diabetic retinopathy. This complication of diabetes happens when high blood sugar levels damage the retina. If diabetic retinopathy goes untreated, it can lead to blindness.

The recent study showed that it is safe to screen type 2 diabetes patients without retinopathy every two years. There was little difference in the number of patients who developed retinopathy, whether they were screened every year or once every two years.

The researchers also found that screening every two years reduce costs for the Royal Devon & Exeter Hospital from £1.83 million (about $2.96 million) a year to £1.36 million (about $2.2 million) a year. They predicted savings of about 25 percent if screening costs remain the same.

"We found that there was no perceivable difference in the effectiveness of screening annually or every two years for this particular patient cohort, which would suggest that it would be safe and cost-effective to increase the screening interval to two years," Dr. Chalk explains.

"I think the best recommendation remains for diabetic patients to have a dilated comprehensive eye exam every year unless directed otherwise by their eye doctor," says Dr. Christopher Quinn, an optometrist with Omni Eye Associates who was not involved in the study.

"There are many factors which can influence the development of retinopathy and it is important to note that retinopathy is not the only ocular complication of diabetes," Dr. Quinn continues. "The degree of control of blood sugar, the duration of diabetes and a variety of other health factors can influence the development of diabetic retinopathy and if the patients eye doctor feels it is appropriate, a longer interval between eye exams could be recommended. I would hesitate to endorse a blanket increase in examination interval which may be confusing to patients and disrupt the routine of having a regular annual eye exam."

Dr. Chalk concludes that "an effective recall system and campaign to impress upon patients the continuing importance of such screening would be beneficial - a lengthening of the screening interval in no way undermines the validity of the screening process itself."

The study, which included more than 3,000 patients, is published online in the journal Diabetes Care.

Review Date: 
May 7, 2012