World Sight Day observed every second Thursday of October, serves to inform of implemented programmes and advocate for additional initiatives toward elimination of preventable blindness and visual impairment worldwide. Blindness is an increasing public health problem as people live longer and the population increases.
This year the spotlight will be focused on diabetic retinopathy which is the leading cause of blindness in the working age group worldwide. However blindness from diabetic retinopathy can be prevented in 90% of cases.
Diabetic retinopathy is a complication of diabetes whereby the blood vessels in the retina are damaged. The retina is the nerve lining inside the eyeball.
The prevalence of type 2 diabetes in Dominica is estimated at 17.7% in the 16-64 years age-group. Therefore about 7,000 persons in Dominica are living with diabetes of which 2000 are likely to have diabetic retinopathy and 400 may need laser treatment. The longer one has diabetes the higher the risk of developing diabetic retinopathy. Uncontrolled blood sugar, uncontrolled hypertension, elevated cholesterol and pregnancy are other risk factors.
The persons diagnosed with type 2 diabetes must have an eye examination at the time of diagnosis. Type 1 diabetics first eye examination should be about five years after diagnosis. Children with diabetes must have their first eye exam at age 10. Follow-up eye examinations must be performed annually or more frequently based on the severity of diabetic retinopathy.
Screening with photos of the retina for early identification of diabetic retinopathy is available in Dominica. Those with diabetic retinopathy are referred promptly to see the ophthalmologist for further eye examination and treatment as laser treatment is available. In addition, primary care doctors are informed for better control of the risk factors.
The presence of diabetic retinopathy also means that there may be damage to the blood vessels in other organs like the kidney and nerves which leads to amputation.
Dominica was the first country in the region to offer fundus photography screening for diabetic retinopathy from 2005. In 2014 Dominica had the leading input in the proposal submitted by the Caribbean Council for the Blind (CCB-Eye Care Caribbean) to the Queen Elizabeth Diamond Jubilee Trust. As a result over a million pounds was provided to fund a 4-year project to enhance screening for and treating diabetic retinopathy in four countries: Jamaica, Belize, St. Lucia and Dominica. Up to £110,924.00 will be used to enhance our programme in Dominica.
Dominica will continue its mobile screening and a fixed screening site at Princess Margaret Hospital will be established. A workshop for stakeholders to operationalize this initiative will be held in the near future.
Primary care physicians should ensure that diabetics check their eyes as part of their management plan. However, the final responsibility is that of the diabetics to book to have their eye photos taken in their health districts and to keep their appointment with the ophthalmologist.
Diabetics have you had an eye exam in the last year? If your answer is NO, arrange to do so as soon as possible.
Prevention is better than cure!
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