Abstract
Diabetes mellitus (DM) is a fast-growing epidemic in the world. Diabetic Eye Disease (DED) is a common microvascular complication of DM that could lead to sight loss if not detected and treated on time. It is a major cause of avoidable blindness and visual impairment. Barriers to implement systematic diabetic eye screening (DES) in low- and middle-income countries are mostly related to major system factors such as lack of human resources and DES infrastructure leading to unavailability of services. Digital retinal imaging is the most advanced and commonly used retinal imaging method currently in use, yet it is a costly intervention for resource poor settings. Therefore, more affordable strategies such as hand-held retinal imaging become popular in DES. Our aim in this chapter is to describe how countries with low resources can improve DES or at least case finding at the outset, by laying out the steps of development and testing of a DES model in Sri Lanka as a case study. In our feasibility study, we demonstrated that DES by physicians using a hand-held digital retinal camera at a medical clinic is one way of case finding that could contribute to systematic screening. We identified that the selection of primary graders, different screening pathways, and transferrable learning methods should be adopted according to local contextual requirements.
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Acknowledgements
Prof. G.V.S. Murthy - Professor of Public Health for Eye Care and Disability (Main Supervisor) and Dr. Jennifer Yip - Associate Professor in Ophthalmology (Co-Supervisor) for supervising the research degree student (first author) at the London School of Hygiene and Tropical Medicine, United Kingdom and Dr. Charith Fonseka - Senior Consultant Ophthalmologist (Co-Principal Investigator of the project) National Eye Hospital of Sri Lanka.
Funding
This project was funded by a Ph.D. student grant received by the first author from Queen Elizabeth Diamond Jubilee Trust (QEDJT) coordinated through the Commonwealth Eye Health Consortium, UK.
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Prof. Congdon declares that he works as Director of Research for Orbis International, an organization working on global eye health and supported by the Ulverscroft Foundation, United Kingdom.
Permission Requests No other party’s permission is required for the material used in this book chapter. The first author holds the copyright of all photos, retinal images, and figures used.
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Piyasena, P., Peto, T., Congdon, N. (2023). Diabetic Eye Screening Using a Hand-Held Non-mydriatic Digital Retinal Camera: Experience from a Lower Middle-Income Country. In: Yogesan, K., Goldschmidt, L., Cuadros, J., Ricur, G. (eds) Digital Eye Care and Teleophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-24052-2_25
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