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Emily W Gower, David S Friedman, Julia A Haller, David J Lee, Cynthia Owsley, Jinan Saaddine, INSIGHT Network; Visual Impairment is Common among Participants in a Community-based Diabetic Retinopathy Screening Program. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5364.
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To quantify the level of walk-in visual impairment of adults with diabetes who present for diabetic retinopathy screening in community-based settings.
The Innovative Network for Site Research group (INSIGHT) conducted a multi-center prospective study of diabetic retinopathy screening among patients with diabetes in community-based clinic and pharmacy settings in Miami, Philadelphia, Birmingham, AL and Winston-Salem, NC. At their screening visit, we queried participants on their most recent eye exam and evaluated presenting distance visual acuity (with spectacles if present) using a Titmus V2 vision screener. All participants received monocular testing for each eye. The better eye acuity was defined as the visual acuity in the better-seeing eye. Significant vision impairment was defined as acuity of 20/50 or worse in the better-seeing eye.
1881 individuals at 4 sites had visual acuity data collected. 63% were female, and the mean age was 54 years. In total, 55% had a dilated exam within the past 2 years. The percent who reported an exam within the last 2 years varied substantially by site, ranging from 26% at Miami to 53% in Birmingham. 22% presented with acuity worse that 20/40 in their better eye and only 30% of patients presented with walk-in 20/20 acuity in both eyes. This percentage also varied by site, with Miami having the lowest percent with 20/20 acuity and UAB having the highest. An additional 49% had mild impairment (20/30 or 20/40 acuity in their better eye). Interestingly, the percent with impairment did not change substantially with increasing time since last dilated eye exam. The percent with impairment increased with increasing age.
The vast majority of these diabetic patients did not have 20/20 visual acuity. This finding highlights the importance of regular eye care for persons with diabetes in order to facilitate their having the best visual acuity possible. Methods to increase participation in eye care need to be identified.
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