Diabetic retinopathy: classification, description and optometric management

BACKGROUND: Diabetes mellitus is an important cause of visual loss, which can be moderated by treatment at specific stages of diabetic retinopathy. Existing monitoring for retinopathy has been shown to fall short of ideal, resulting in unnecessary visual loss. Using appropriate guidelines, optometrists should be well-placed to contribute to the management of patients having diabetic eye disease. METHOD: The underlying pathology of diabetic retinopathy is reviewed as a basis for recognising the various stages of diabetic retinopathy, including macular oedema and risk of progression of disease. These stages are detailed in terms of classification, prevalence and appropriate examination techniques. An illustrated guide summarises these features and provides a suggested management regimen for continued monitoring, reporting, referral and ongoing management by optometrists. CONCLUSIONS: The majority of optometrists have the diagnostic skills and the clinical equipment required for efficient monitoring of diabetic retinopathy. Inclusion of optometrists in the team providing health services for diabetes is an economic and practical solution to improving the primary eye care of people having diabetes and ensuring a significant reduction of unnecessary visual loss caused by diabetic retinopathy.