UI Department of Ophthalmology
Screening for eye diseases caused by diabetes is often a difficult task in rural areas of Iowa. A team of University of Iowa researchers is working to change that. Michael Abramoff, MD, UI Hospital and Clinics ophthalmologist, offers these comments:
What does this new approach involve?
First, I want to tell you that diabetes is the most important cause of blindness in the adult population in the U.S., and about 25,000 people go blind every year as a cause of diabetes.
We know that if patients can regularly get a dilated eye exam, blindness can be prevented in most cases. However, up to 50 percent of patients with diabetes do not have these dilated eye exams on a regular basis, so that's a problem.
In Iowa and other rural parts of the Midwest where eye care maybe far away it can be difficult to access eye care providers.
So we put special digital cameras in family physician offices where pictures can be taken of the back of the eye and then, using the Internet, these images are sent to us at The University of Iowa, where retinal specialists diagnose these images to see whether these patients have any problems.
If they do, the family physician refers the patient to an ophthalmologist. And most of the patients, have normal readings and can just have their eyes photographed again in a year.
Where are you currently using these screening cameras?
Right now we have cameras in 30 clinics all over Iowa. We have cameras in clinics in southeast, Iowa, northeast Iowa, northwest Iowa and we have one in Nebraska and we'll soon be installing a camera in Texas. While it's more than just Iowa, but we're focusing mainly in Iowa and we're hoping to recruit at least 10 more clinics over the next year.
What are your preliminary results showing?
It's quite interesting, actually, because while we offer this diagnostic service, we do research this way. We ask patients whether they want to participate in the research.
You might expect that some people might find it a problem being diagnosed by a camera and not see in person the ophthalmologist or any other retinal specialists here at The University of Iowa. They might feel concern about the quality of what is happening.
What we see is that they much prefer this over actually going to an ophthalmologist in most cases. So we see that it seems to give them a feeling that it's a good quality of care. This is pretty exciting, I think.
Why is this project important?
Blindness is obviously very debilitating, especially if you live in a rural area. We know how to prevent this, but if patients come in with complaints, it can be too late. If dilated eye exams are done as a prevention measure, you can actually prevent most cases of blindness. I think it's very important to prevent blindness in these patients who may have other problems because of the diabetes.
If this is successful, what are your plans for the future in terms of offering this service on a wider basis?
As I was saying, we hope to recruit at least 10 more clinics in Iowa over the next year. We are getting calls from all over the Midwest interested in this service. One of the main reasons we're going slow is that the cost of the camera is quite high. We have grants from the National Institutes of Health to develop lower cost, better quality cameras.
Where can people find more information about this service?
The first person to turn to is whoever is monitoring the care of their diabetes-maybe the family physician or the internist. |
