Providing excellent diabetes care includes the regular provision of screening for diabetes retinopathy—one of the leading causes of blindness in the world. Only a thorough ophthalmologic exam that can detail and examine the retina will suffice as sufficient screening. The examination in the office of a primary care physician using an ophthalmoscope is insufficient in identifying diabetic retinopathy changes. Therefore, the primary care physician must provide referrals to ophthalmology services, communicate with the ophthalmologist in a bidirectional manner, and ensure that such services are provided annually. Given the complexity and interplay among stakeholders—the patient, primary care physician, and ophthalmologist—systems-based changes and solutions with strict office-based processes and an educated and engaged patient are most likely to yield higher rates of screening. Increasingly, the use of telemedicine is further expanding access to qualified ophthalmology services.

Eye Health Resources

Resource Link Brief Description of Resource
Diabetic Retinopathy Article: American Diabetes Association, Diabetes Care

An article providing basic information about diabetic retinopathy.
Increasing Eye Care Screening & Referral for People with Diabetes via Telehealth Programs (PDF, 58 KB) Article: Nebraska Department of Health and Human Services

A review of programmatic changes that include multiple tools and approaches.
Effect of multiple patient reminders in improving diabetic retinopathy screening – A randomized trial (PDF, 624 KB) Article: American Diabetes Association, Diabetes Care

A small study demonstrating the impact of using patient reminders to improve retinopathy screening.
Improving Diabetes Care in Practice: Findings from the TRANSLATE trial Article: American Diabetes Association, Diabetes Care

The introduction of a multicomponent organizational intervention in the primary care setting (including implementation of an electronic diabetes registry, visit reminders, and patient-specific physician alerts) significantly increased the percentage of patients with type 2 diabetes achieving recommended clinical outcomes, including increasing annual eye examinations 25.9%.
Retinopathy Screening and Treatment Toolkit: Agency for Healthcare Research and Quality (AHRQ)

A toolkit for remote retinal screening diagnosis and treatment of retinopathy for poor and/or uninsured patients with diabetes.
Online continuous quality improvement for diabetic retinopathy tele-screening Article: Telemedicine Journal and e-Health

An article outlining online continuous quality improvement for diabetic retinopathy tele-screening.
Guide to Culturally Specific Retinopathy Screening (PDF, 281 KB) Manual: Michigan Diabetes Research and Training Center

A manual for screening for retinopathy and guide to culturally specific retinopathy screening.
Improving Diabetic Retinopathy Screening Through a Statewide Telemedicine Program at a Large Federally Qualified Health Center Article: Journal of Health Care for the Poor and Underserved

An article highlighting a wide scale initiative to improve access to ophthalmologists using telemedicine.
Working Together to Manage Diabetes: A Guide for Pharmacy, Podiatry, Optometry, and Dentistry (PPOD) (PDF, 428 KB) Resource: NDEP PPOD Guide

Links to a sampling of resources for pharmacy, podiatry, optometry, and dentistry (PPOD) specialties