Teleophthalmology (diabetic retinopathy)

Diabetic retinopathy (DR) is a complication of diabetes resulting from damaged blood vessels of the retina that threatens the visual prognosis which affects approximately 40% of people with diabetes.

The prevalence of diabetes is higher among First Nations; likewise, vision loss due to diabetic retinopathy is higher among Canada's Aboriginal population.

The majority of those inflicted are asymptomatic in the early stages of the evolution of the disease.

Rarely, the following symptoms may appear:

  • A sudden loss of vision in one eye or both eyes;
  • Blurred or double vision;
  • Fluctuating vision;
  • Floating or blind spots in the field of view.

Well controlled diabetes can slow the progression of DR.

There are different treatments that are very effective. The treatment of the DR depends on the stage of the disease and seeks to prevent or slow its progression. Preventing complications that threaten the visual prognosis is far preferable to the treatment of an established condition and that is why screening for DR is among the best practices in terms of the overall and optimal management of any person with diabetes.

Remote screening

Through teleophthalmology, remote diabetic retinopathy screening clinics aim to increase access among First Nations to screening for this disease in addition to ophthalmological specialist care. This service is part of the prevention of diabetes in the non-Agreement communities in Quebec.

In the context of the telehealth projects, the scanning of the fundus of the eye is performed remotely using information technologies to establish a connection between the patient and the specialist.

First, the patient is evaluated and photographs of the patient's retina are taken using a non-mydriatic retinal camera by a specially trained technician from the community. The images are sent over the Internet, through a secure network, to an analysis centre where an ophthalmologist can examine the images and make a diagnosis.

Thereafter, the ophthalmologist makes recommendations and forwards a copy of the scan report to the general practitioner and the nurses in the community, who ensure that the patient receives the necessary follow-up if needed. The patient then receives a letter informing him or her of the outcome of the examination. 

This service is intended for all First Nations with type 1 and type 2 diabetes in the communities where the service is offered.  

Objectives

The screening clinics aim to:

  • Reduce the incidence of blindness and loss of sight among First Nations;
  • Ensure access to DR screening and competent specialists;
  • Consolidate the activities included in the diabetes management program in the communities by focusing on prevention and early detection activities for diabetes and its complications;
  • Foster First Nations capacity-building by training specialized diabetes agents and nurses who are able to perform DR screening;
  • Develop collaborative linkages between the health workers and First Nations.

Information

For more information on the teleophthalmology project, you can contact Isabelle Cornet: