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IAPB Essential List: Diabetic Retinopathy

Challenges to the prevention of blindness from diabetic retinopathy

Although early identification and treatment can prevent almost all blindness from diabetic retinopathy (DR), many people with diabetes mellitus (DM) are unaware of their condition and that they should have their vision examined regularly. Many are asymptomatic during the early stages of DR, and fail to access timely care.

Further their opportunities to access to care may be limited. In many Low-and-Middle-Income (LMIC) countries, and in remote locations, the health personnel, technology, and systems of care needed to identify and effectively treat DR are often lacking. Screening should obviously be confined to where treatments are possible. Even where surgical interventions are not yet available, early non-invasive treatments (i.e., pharmacological, intensive blood glucose control) need to be explored and their implementation facilitated. Such applications have shown promise in mitigating the deterioration of DR.

An integrated approach

This Essential List recognises a multifaceted approach is required to reduce the risk of developing DR and slow its progression as described in “Strengthening health systems to manage diabetic eye disease: Integrated care for diabetes and eye health“. This document calls for a patient-centred approach and collaboration across the diabetes and eye health sectors.

The figure below describes the services for DR screening monitoring and treating at various levels of the health system.

This list also reflects the procedures and requirements outlined in the ICO Guidelines for Diabetic Eye Care.