Ophthalmic disease in diabetes mellitus: management from primary health care

• Published in: Atención primaria 2011-01, Vol.43 (1), p.41-48
• Main Authors: Sender Palacios, María José, Vernet Vernet, María, Maseras Bové, Miguel, Salvador Playà, Antoni, Pascual Batlle, Laia, Ondategui Parra, Juan Carlos, Jovell Fernández, Esther
• Format: Article
• Language: Spanish
• Subjects: Aged; Diabetes Complications - diagnosis; Eye Diseases - diagnosis; Feasibility Studies; Female; Humans; Male; Primary Health Care; Prospective Studies
• ISSN: 1578-1275
• DOI: 10.1016/j.aprim.2010.01.005

To study the feasibility of a basic ophthalmological examination for the eye disease in diabetic patients by Primary Health Care (PHC). A multi-centre prospective study. A sample of 712 type 2 diabetics. Visual acuity examination, intraocular pressure measurement and the eye fundus photograph with a non-mydriatic camera taken by an optometrist. The interpretation and subsequent referral to an ophthalmology department by ophthalmologists and general practitioners (GP). Visual acuity deficiency: GP, 43.7%; ophthalmologist, 36.1%; concordance, 70%; glaucoma suspicion: GP, 8.8%; ophthalmologist, 7.6%; concordance, 94%; diabetic retinopathy: GP, 28.2%; ophthalmologist, 13.4%; concordance, 78%. Ophthalmology Department referral: GP, 56.8%; ophthalmologist, 41.3% (P=0.001). Agreement between GP and ophthalmologist leads to a reliable ophthalmological examination of the diabetic patient in PHC. Despite an over-diagnosis and 16% of non-justified referrals by the GP, Ophthalmology Department referral is avoided in almost half of the diabetic patients.