Use of Eye Care Services among Type 2 Diabetic Patients in Laguna

Abstract

Objective: The aim of the study was to determine the prevalence of diabetic patients seeking an ophthalmic evaluation for diabetic retinopathy. Specific objectives were to describe the prevalence and risk factors for diabetic retinopathy (DR) in a group of diabetic patients referred for retinal evaluation from different internists in Laguna by screening using digital retinal photography.

Methods: The study was a hospital-based mixed method study involving two portions: quantitative (cross-sectional) and qualitative. The cross-sectional portion involved patients diagnosed with type 2 diabetes by internists from San Pablo Colleges Medical Center referred for retinal evaluation using a non-mydriatic retinal camera. Retinal photographs were categorised for the presence and severity of diabetic retinopathy according to the international clinical DR severity scales recommended by the Global Diabetic Retinopathy Project Group. The qualitative portion involved a focus group discussion among diabetic patients and a short key informant interview with the referring internists.

Results: Sixty-seven (67) diabetic patients were evaluated for diabetic retinopathy (DR) using digital retinal photography. The overall prevalence of any DR was 26% (n=18): 55% mild NDPR, 33% moderate NDPR, 6% severe NPDR and 6% PDR. Diabetic macular edema (DME) was present in 22% of patients with any form of DR. The focus group discussion reported the following reasons for consulting an ophthalmologist: presence of blurring of vision, availability of budget, knowledge of the need for ophthalmic evaluation, and order for evaluation by the internist. Interviews among the referring internists revealed three primary reasons for referring: history of visual disturbances, uncontrolled diabetes and finances of the patient.

Conclusion: This study presented a lower prevalence rate of diabetic retinopathy among patients who underwent digital retinal photography compared to that of other studies published in the Philippines. Nevertheless, it is important to continue patient education with regards to diabetic complications in the eye, and improve the referral system among medical practitioners.