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    Care lacking for diabetic eye diseases worldwide

     

    Over half of the ophthalmologists surveyed said that their patients’ limited education about diabetic eye diseases was a serious problem. Patients agreed, with almost a third reporting that they had not received any information on eye complications from “traditional” sources, such as their doctor or nurse.

    Over half of providers did not have information on diabetes and potential eye complications or had inadequate information to offer their patients, according to the surveyors. They reported that patients didn’t seem to understand the importance of eye exams, or thought the risk of eye-related complications was small.

    While patients said that loss of vision was the complication of diabetes they feared the most, 20% thought their vision problems were a normal part of aging, and some did not schedule screening or make any other special effort to prevent these problems.

    Both patients and ophthalmologists said there were long wait-times for appointments, and a third of the patients said that the costs of appointments were prohibitive. A quarter said they were deterred by long wait times once they arrived for the appointments. Almost 1 in 5 reported limited access to eye examinations near their homes.

    Close to two-thirds of ophthalmologists believe that late diagnosis is the greatest barrier to improving outcomes, with over half saying that people with diabetes present when vision problems have already occurred, and in many cases when it is too late for treatment.

    Over a quarter of patients had either never discussed eye complications with their health care professional or did so only after the onset of vision loss symptoms.

    The patients mentioned a variety of other challenges to managing their diabetes, including the difficulty of eating well, competing priorities, and not wanting to think about having diabetes.

    About a quarter of patients said that the high cost of care and long wait times to see their specialist limited their access to care. They said that free or low-cost medicines were essential to them, but they also depended on support from family and friends and on health education.

    Of those with diabetic macular oedema, 42% were enrolled in a diabetes support program to help them manage their diabetes, almost double the proportion of those with diabetes who did not have macular oedema.

    Ophthalmologists were struggling with their own challenges. One in five said they lacked guidelines on referrals and screening, a finding that puzzled the researchers since international guidelines, such as the International Council of Ophthalmology Guidelines, can be readily accessed.

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