Journal of Preventive Medicine

Screening for Diabetic Retinopathy by Non Optholmologist: A Tak Shifing Approach for Low and Middle Income Countries

Diabetic Retinopathy (DR) is a devastating ocular complication of diabetes mellitus that is expected to affect approximately 200 million people globally by 2030 ver time, high blood sugar levels can cause damage to retinal blood vessels, which can result in leakage, swelling, constriction, and outgrowths of these vessels. Damage to retinal blood vessels causes one’s vision to become cloudy or blurred, and if not treated in a timely manner these changes can become permanent.

Approximately 35% of diabetic patients develop DR over the course of the disease. If left untreated, DR can progress to partial or even total blindness; however, early intervention is effective in preventing the development of blindness. In fact, regular eye examinations in diabetic patients have been shown to prevent approximately 98% of diabetes-related vision loss. Early diagnosis and treatment is the gold standard in preventing blindness. DR screening aims to detect sight threatening lesions while they can be effectively treated with photocoagulation or anti-Vascular Endothelial Growth Factor (VEGF) injections into the eye, preventing their progression and blindness. Accordingly, many countries have developed comprehensive screening programs to detect DR in its early stages.

More than 80% of the diabetes and sight-threatening DR burden is concentrated in low- and middle-income countries, especially India and China. Low and Middle Income Countries (LMIs), as defined by The World Bank, are disproportionally affected by DR due to the rising prevalence of obesity, sedentary lifestyles, and lack of DR screening and treatment as a result of poor healthcare infrastructures.

Author(s): Mohammad Mostofa Sarwar, Jahar Bhowmik, Thanh T Nguyen and Fakir M Amirul Islam

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