Diabetic Retinopathy

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
2 https://www.cdc.gov/diabetes/ndep/pdfs/ppod-guide-eye-care-professionals.pdf
4 https://www.diabetes.ca/diabetes-and-you/complications/eye-damage-diabetic-retinopathy
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).
6 http://care.diabetesjournals.org/content/15/7/815
7 http://care.diabetesjournals.org/content/15/7/815
8 https://nei.nih.gov/health/diabetic/retinopathy
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.