Diabetic Retinopathy: A Public Health Imperative
Diabetes exacts a very heavy burden on the health care system. In 2016, 3.5 million Canadians had diabetes, a figure expected to rise to nearly 14 million by 2026.1 The associated costs of managing diabetes are currently estimated at $3.4 billion, increasing to $5B over the next ten years.2
Impact of Diabetic retinopathy (DR)
- The risk of blindness is 25 times higher for someone with diabetes3, making it the leading cause of blindness in Canada. 4
- Early detection and prompt treatment can prevent diabetes-related visual impairment5
- Through comprehensive eye examinations at regular intervals, optometrists can uncover retinopathy at its earliest stages. This would allow for timely referral to a physician for treatment of diabetes, and result in lower system costs.
- Diabetic retinopathy is seen in 20% of cases of newly diagnosed diabetes6, which suggests that a person has been experiencing the damaging effects of the disease for four to seven years prior to diagnosis7. With early detection, timely treatment and appropriate follow-up care, there is a 95% reduced risk of vision loss.8
- Biannual vision examination and treatment of diabetic patients is a cost savings measure compared to general practitioners delivering this service 9
Swift action required to address eye health and vision loss among diabetic patients
- Build a pan-Canadian Framework for Action, coordinated by a Vision Desk at PHAC, that:
- is patient-centered and ensures access to the right eye health provider at the right time
- promotes national vision health guidelines including an annual, comprehensive in person eye exam for patients with diabetes
- ensures the best outcome for diabetic patients by incorporating optometrists in collaborative care teams
- approaches eye health as a population health priority, and encourages its integration into patients’ preventive health care routine.
- Educate the public by promoting the value of comprehensive eye examinations to detect and help monitor diabetic retinopathy through a multi-stakeholder public information campaign.
- Fund research on diabetic retinopathy and preventative measures
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2 ibid
3 Thomann KH, Marks ES, Adamczyk DT. (2001). Primary Eye care in Systemic Disease; New York: McGraw-Hill. Cited in
5 Ting, D., Cheung G., Wong, T. (2016). Diabetic Retinopathy: global prevalence, major risk factors, screening practices and public health challenges. Clinical and experimental Ophthalmology: Diabetes Special Issue. 44(4).
9 Tu, H., Wedge, R., Yaping, J., Trope, G., El-Defrawy, S., Flanagan, J., et al. (2014). Cost-effectiveness Analysis of insured eye care services by optometrists in Prince Edwards Island: An example of diabetic retinopathy management. Presentation at Value in Health Conference, University of Toronto, Toronto, Canada.
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