Why Primary Care Providers Should Screen for Diabetic Eye Disease

Diabetes has reached epidemic levels in the U.S., and the sight threatening implications are equally alarming. According to the National Eye Institute, roughly 40%-45% of Americans diagnosed with diabetes have some stage of diabetic retinopathy (DR). However, only about half are aware of it. DR remains to this day, the number one cause of severe visual impairment in the working-age population. Early detection can reduce the likelihood of visual impairment or blindness in up to 95% of cases.

Patient adherence with screening guidelines is critical to prevent blindness from diabetic eye disease. However, diabetic retinopathy screening rates in the U.S. have stagnated at 50% or even lower among certain segments of the population.

Standard procedure for many PCPs is to refer patients with diabetes to eye care providers for a fully dilated eye exam. Evidence shows that about 40% of these patients do not follow through with these visits, even after they have been asked to do so by their primary care physician.

Most people with living diabetes will visit their primary care provider multiple times during the year for ongoing monitoring of their condition. This offers an excellent opportunity for these providers to screen for diabetic retinopathy in their practice. By enabling primary care providers to screen for diabetic eye disease, patients could receive a quick and convenient “on-the-spot” retinal exam thanks in large part to affordable, easy-to-use retinal cameras and teleretinal screening technology.

For some primary care practices, the notion of offering “eye exams” seems out of place. Some believe that eye exams are the domain of optometrists and ophthalmologists. Well, that might be true but consider these alarming statistics: according to one recent large-scale study of insured patients, almost half with type II diabetes had no eye exam visits over a 5-year period and only 15.3% met the American Diabetes Association recommendations for annual or biennial eye exams. This is a critical diabetes care gap that PCPs can help close. It’s also important to point out that diabetic retinopathy screening is not a substitute for a comprehensive clinical eye exam. It is simply a means to improve convenience and access and to detect the diabetic eye disease in its earliest stages.

Since diabetic eye exams are now part of the NCQA HEDIS, the Medicare Advantage STAR and Medicare quality ratings programs, PCPs need to take control of their quality measures. Even referring out to eye care providers for diabetic eye exams does not always result in gap closure attribution for PCPs. One quick and easy solution is to offer diabetic eye exams on-site in their practice. Screening only takes a few minutes, and with today’s retinal cameras, any clinical or administrative employee can operate use the device with minimal training.

Is your practice ready to get on-board and help eradicate preventable blindness caused by diabetic retinopathy?