Patterns of diabetic eye care by primary care physicians in the state of Indiana

Diabetic retinopathy is the leading cause of new blindness in the 20 to 74-age group in the United States. The American Academy of Ophthalmology (AAO) and American Diabetes Association (ADA) have recommended guidelines for eye examination to assist primary care physicians in managing these patients. The purpose of this study is to investigate the patterns of diabetic eye care offered by primary care physicians in the State of Indiana. A survey questionnaire was sent to 1279 primary care physicians in central Indiana. Of those surveyed, 259 (20%) responded. Thirty-five percent of respondents stated that they never refer patients for ocular examination while 26% refer all patients. The remainder refer on a case-by-case basis. Patients who are not referred have their fundus examined only 70% of the time by the primary care physician and 96% of these examinations are performed with an undilated pupil. When referred, 20% of Type I patients are referred at the time of diagnosis and 50% by one year. Of the Type II patients, only 2% are referred at the time of diagnosis and 70% by one year. Ophthalmologists receive 75% of the referrals while optometrists receive 20%. Our results show that a significant number of primary care physicians in the State of Indiana do not follow the recommended guidelines set forth for diabetic eye care.