Abstract
A case experience of initiating the ocular fundus photography (OFP) service in a diabetes outpatient clinic of a tertiary-care institution is presented. In the community and within the hospitals, the OFP helps to develop the three-tier diabetic retinopathy (DR) care system comprising: OFP-based DR screening and monitoring, an experienced ophthalmologist in laser therapy, and vitreo-retina specialist services. After three to six months of training, non-ophthalmic allied health professionals could also grade the DR. We also learned that such training program, however, requires broadening to encompass diabetes and major non-communicable diseases comprehensively to fulfill the need of the primary care nurses in health care settings and the full-time job and professional career for them. Medical students and residents now need to be 'directly' trained in the interpretation of OFP. The stakeholders involved in public health and medical education may recommend to the public hospitals and medical colleges for the provision of OFP service.
Highlights
Diabetes is one of the fastest-growing global health emergencies of the 21st century.[1,2] Almost 80% of people with diabetes live in low and middle-income countries and are the working-age group.[1,3,4] Vision-threatening diabetic retinopathy (VTDR) can be present even in newly diagnosed diabetic patients.[5]
The five learning points from the case experience are discussed with their practical implications
Non-mydriatic retina imaging is recommended for screening of people with diabetes in all non-ophthalmic settings.[3,6,9]
Summary
Fundus Photography as the Base of Three-Tier Diabetic Retinopathy Care System to Its Wider Roles: Learning from a Case Experience. Madhur Dev Bhattarai,[1] Raba Thapa,[2] Manil R Bajracharya,[3] Lochan Karki,[3] Budda B Karki,[3] Alark D Rajouria[3]
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