The Integration of Diabetic Eye Screening into Hemodialysis Units in Northern Ireland.

Abstract

Diabetes is rising globally and is the most common cause of both end-stage renal disease and blindness. People on hemodialysis have to attend several dialysis appointments per week, which can affect their attendance at diabetic eye screening. In addition, previous literature suggests patients on hemodialysis are more likely to have sight-threatening diabetic eye disease. This study aims to determine attendance at the Diabetic Eye Screening Program in Northern Ireland, diabetic retinopathy severity, and use of handheld retinal imaging in people with diabetes attending hemodialysis units in Northern Ireland. All patients with diabetes attending hemodialysis clinics regionally were screened and graded by the Diabetic Eye Screening Program in Northern Ireland using a handheld and/or conventional nonmydriatic fundus camera. All eligible people (N=149) were offered a Diabetic Eye Screening Program in Northern Ireland appointment, 132 attended, 34% of whom had not been seen in >3 years and 15% of whom had never attended the Diabetic Eye Screening Program in Northern Ireland despite multiple previous appointments. Altogether, 13% required urgent referral to hospital eye services, which is significantly higher than the national average of 0.4%. Those on hemodialysis are at high risk for sight-threatening diabetic retinopathy. Implementing the Diabetic Eye Screening Program in Northern Ireland in hemodialysis clinics enables timely diagnosis and referral.