Practice patterns of South African optometrists for diabetic eye care

Optometrists play a key role in the provision of diabetic eye care. Timely and accurate diagnosis and management of the ocular complications of diabetes mellitus can ensure optimal patient outcomes and minimise vision loss.

Diabetes mellitus is a global public health concern. Diabetic retinopathy is a complication of diabetes mellitus and the leading cause of vision impairment globally, particularly in low- and middle-income countries. Despite optometrists playing a critical role in diabetic eye care, their clinical practices remain underreported in South Africa. The objective of this study was to determine practice patterns of South African optometrists towards diabetic eye care.

In this cross-sectional study conducted in South Africa, a validated online questionnaire was distributed to optometrists to explore their self-reported practice patterns towards diabetic eye care.

The sample comprised 254 participants. Most participants were confidence in grading (62.2%) and managing (74.8%) diabetic retinopathy while some were confident in detecting (45.7%) and managing (47.3%) diabetic macular oedema. The majority of participants had fundus cameras (90%) but only 25.2% had optical coherence tomography devices and of these 85% found them useful for diabetic macular oedema detection. Many participants (54%) used classification systems and guidelines for diabetic retinopathy with a significant association between routine use of these tools and confidence level (p = 0.02). Approximately 52% felt that current clinical guidelines should be reviewed and revised.

There exists a need for greater access to optical coherence tomography, standardised national guidelines, and diabetic focused clinical training in South Africa. This will enhance diagnostic confidence, streamline referrals and reduce vision loss associated with diabetic eye disease.