Visual acuity screening for diabetic maculopathy

Abstract

AbstractWe have investigated the use of visual acuity (VA) as a screening test for diabetic maculopathy in an outpatient setting. The best corrected VA was recorded under standardised conditions in 197 of 223 randomly selected patients ⩾ 50 years old. True VA was ⩽ 6/12 in one or both eyes of 69 patients (35%). Of 183 diabetic case notes examined, 51% had no VA previously recorded. In the remaining patients, results differed from last recorded VA in 46% of eyes. An ophthalmologist examined 110 patients without knowledge of VA and his findings were combined with details of recorded eye examinations of 50 patients already attending an eye clinic. Eighty‐nine per cent of patients with subnormal acuity had “clinically discernible eye disease” compared with 23% of those with normal acuity. Twenty‐two per cent of patients with subnormal acuity had diabetic maculopathy compared with 1% of those with normal acuity. A normal VA provides reasonable assurance that maculopathy is not present and, when expert fundoscopy for elderly patients is in short supply, specialist attention should be concentrated on patients with abnormal acuity.