Year: 2020
Type: article
Abstract: Objectives: Between 2019 and 2045, the prevalence of Diabetes Mellitus (DM) will double; associated withthis, the burden of Diabetic Retinopathy (DR) is also expected to increase, especially in low-resourced settings.To prevent avoidable visual impairment and blindness, early detection through screening and early treatmentare necessary. To enable access to these services, we developed the Lions Diabetic Retinopathy Project forsouthwestern Uganda to serve the region including 17 Districts with eight million inhabitants.Methods: A three-pronged strategy for mass screenings levering the existing general health system andopportunistic screening of higher-risk population. Capacity building involved training a vitreoretinal surgeonand allied eye care providers, installing critical infrastructure at the referral eye hospital, and acquiring equipmentfor primary health centres.Results: In 1.5 years, 60 DR screening camps were implemented; this led to screening of 9,991 high riskindividuals for DM and 5,730 DM patients for DR. We referred 1,218 individuals with DR for further managementat the referral eye hospital, but only 220 (18%) attended referral. The main barrier for not attending referralwas long travel distance and the associated direct and indirect costs. Human resources trained included 34ophthalmic nurses, five midlevel providers, and one vitreoretinal surgeon. Major equipment acquired includeda vitrectomy system, an outreach vehicle, and non-mydriatic fundus cameras.Conclusions: DR screening can be implemented in a resource-limited setting by integrating with the generalprimary healthcare system. However, geographic barriers stymie delivery of therapeutic services and we needto establish models to bring these services closer to areas with poorer access.
Language: English
Topic: Retinal Imaging and Analysis
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7214308443