Diabetic retinopathy screening by general practitioners using non-mydriatic retinography

Diabetic retinopathy (DR) is the leading cause of visual loss in people aged 30 to 69 years. Most authorities recommend screening of the ocular fundus to prevent severe visual loss. The increasing incidence of diabetes mellitus and fewer ophthalmologists in many countries is leading to inadequate screening. Establishing an adequate system for DR screening is a complex issue and represents a challenge for most health authorities. To alleviate the burden of DR screening for most health systems, some investigators have suggested that general practitioners (GPs) perform the initial screenings. The aim of this article was to review the current status of DR screening performed by GPs using non-mydriatic retinography. The five studies analyzed in this review indicated that after adequate training GPs can be effective and reliable screeners of DR using non-mydriatic retinography. Including GPs in the screening model would be a useful way to alleviate the increasing demands of ophthalmic care resulting from the increased prevalence of diabetes mellitus. In addition, GPs would have full control of the diabetic process, which could bolster their motivation and confidence in other areas of diabetes care and medical practice.