A diabetic retinopathy screening program as a strategy for blindness prevention

The most frequent cause of preventable blindness in adults, in the developed world, is diabetic retinopathy (DR). The early treatable phase of this complication is clinically silent. In order to institute effective laser photocoagulation and prevention of blindness, timely detection is crucial. Consequently there is a need for periodic funduscopic examinations of all diabetics. Due to the high prevalence of DM in Mexico most of the primary care facilities are limited. We present the results of a DR screening program (DRSP) using a mobile unit equipped with a fundus photography camera, parked outside of a clinic. We report the prevalence of the various stages of DR and clinical characteristics observed in this population as well as our experience working in such an environment. The study period was from September 1 to December 22, 1995. All the diabetics that presented for care to the clinic were identified and all other persons were invited to participate. A total of 231 participants were invited (112 men, 119 women). Non-stereo fundus photos of two retinal fields (macula and optic disk centered) were taken with technique and classification according to international standards. Response rate to the invitation was 95.3%. Mean age was 62.4 +/- 13 years and 63.5 +/- 10 years and duration of diabetes was 12.3 +/- 10.1 years and 11.0 +/- 7.5 years for men and women, respectively. DR was detected in 38% of the cases, of these only 5.6% have received treatment. DR was uncovered in 84.5% of the cases and was associated with duration of diabetes (p < 0.001 in men and p = 0.04 in women) and hyperglycemia (in men p < 0.005, only). DR has a high prevalence in this population and can be detected through a screening program which reveals undiagnosed high risk DR in an efficient, and standardized manner.