Report on the creation of a diabetes register and retinopathy screening outcomes in the Mid-West of Ireland.

Abstract

With concerns that blind registration in Ireland due to diabetic retinopathy is continuing to rise, a structured retinopathy screening service is in the process of being rolled out nationally. To report on the validation process for creating a register of diabetics in the Mid-West of Ireland, and findings following retinopathy screening of a representative sample. National primary care databases were employed in generating provisional lists of diabetic patients in the Health Service Executive (HSE) Mid-West area. Subsequent engagement with the corresponding general practices over a three year period between 2010 and 2013 facilitated the validation of these lists. A summary of the retinopathy screening outcomes of 1,434 patients and pre-existing screening patterns is reported. The number of patients on the Mid-West diabetes register to date is 11,126. Of the 1,434 patients screened, 288 (20.1 %) had background retinopathy, while 117 (8.2 %) had sight-threatening retinopathy. Seventeen (19.8 %) of the 86 patients identified with maculopathy required treatment with intravitreal injections. Of the 610 patients questioned about previous screening events, 389 (63.8 %) said they had undergone an ocular examination within the previous 12 months. The HSE Mid-West has over 11,000 patients on its database ready to be screened by the national programme, with the treatment of maculopathy expected to have the largest impact on resources. Although the majority of patients are already undergoing screening in the community in an ad hoc fashion, the rates of sight-threatening retinopathy encountered highlight the timeliness of the full implementation of the national programme.