Diabetic Retinopathy (DR) screening programme in Urban

area-Lessons learned.

Kuldeep Dole, Sucheta Kulkarni, Madan Deshpande,Nilesh Kakade,

H.V.Desai Eye Hospital&

Rishi Raj Borah ,

ORBIS International,India

Diabetic Retinopathy Screening Programme- SAVE YOUR SIGHT

GoalReducing morbidity and disability and improvequality of life for persons with diabetic Retinopathy.

Objectives• To generate awareness about Diabetic Retinopathy.• To identify patients with Diabetic Retinopathy by screening diabetics in the hospital and community .• To provide appropriate Management of Diabetic

Retinopathy.

Knowledge , Attitude, Practice Survey

Materials and media development

Communication Strategies

Awareness creation

HOARDINGS

PBMA’S H.V.DESAI EYE HOSPITAL

EXHIBITIONS

POSTER ON PUBLIC TRANSPORT

Rally on world diabetes day

GROUP MEETINGS-CORPORATES

ONE TO ONE COUNCELLING

Screening Services• Training a team(clinical and programme)• Equipments procured• Opportunistic and organized screening

activities- diabetic clinic and camps were arranged

• Protocols developed• Data collection and analysis

Diabetic Clinic - HBP training

Outreach Camp

Community Paramedics Doctors

Knowledge about DR 46.8 % 76.3 % 95 %

Knowledge about Risk of DR 0.4 % 49.5 % 92.5 %

Knowledge about Treatment of DR 2.5 % 68.8 % 57 %

KAP survey

Analysis of effective communication strategy

Media  Responses  %

Mass media 35 36.10%

Papers-advertisement 28 28.90%

Pamphlets 1 1%

T.V. 5 5.10%

One to one publicity 28 28.90%

  97  

Opportunistic screening :Diabetic Clinic

Year 2009 2010 2011

DM 1914  2935 3697 

DR 490 (26.2%) 523 (18.5%) 407(11%)

Sight threatening

DR 255 (13.6%) 281(10%) 189 (5.9%)

DR examination cost /patient Rs.64.19

Organized screening-Camps No of

camps Total DM DR Sight

Threat-ening

DR

Eye camps –Cataract

109 8246 907 (11%)

151(16.6%)

56(6.17%)

Health checkup camps including eye 375 18757

1149(6.1%)

145(12.6%)

27(2.3%)

DR campsCommunity supported

8 654 169 (25.8%)

37 (21.9 %)

13(7.7%)

DR campsPhysician supported

61 2068 2068(100%)

341(16.5%)

70(3.4%)

Treatment  

Total LASER VR Anti-VEGF

2009 584463

(79.28%)43

(7.36%)78

(13.36 %)

2010 658516

(78.42 %)54

(8.21 %)88

(13.37%)

2011 625413

(66.08%)103

(16.48%)109

(17.44%)

Total 2492 1867 249 278

Laser treatment cost /sitting /patient Rs.1001.82

Compliance to Treatment Total pt 84

Treatment completed 40 (47.6 %)

Treatment not completed

44 (52.4 %)

Laser treatment not completed

25 (56.8 %)

PPV and Intrvitreal injection not completed

19 (43.2 %)

Undiagnosed DR Networking

DR screening services at various levels Awareness creation ,

Media campaign Networking with Physicians

,NGO working for DM

Complex treatment

Team Approach Capacity building – support of Lab and Physician

Poor compliance to treatment

Counseling Dedicated counselor-good documentation

Low level of Awareness

Health Education

Awareness campaign – Dedicated personnel

Unaffordable cost To subsidies Cross subsidize

Lessons learned

Acknowledgment

• Dr.G V Rao ,Mehnaz Riaz–ORBIS India• Dr.Pravin Narwadkar-Project manager• Mr.Vishnu Gaikwad• Mr.Jitesh Kharat• All the doctors and staff of H.V.Desai Eye

Hospital

Lions’s Juhu Community Ophthalmology InstitutePBMA’s H.V.Desai Eye Hospital

93 Tarwade vasti,Mohammadwadi,HadapsarPune-411060

Email-desaieyehospital@hvdeh.orgPhone - + 91 20 26970043 +91 20 26970144