Background
Diabetic retinopathy, blindness, Diabetic Retinopathy, diabetic, vision loss, Non-proliferative Diabetic Retinopathy, diabetes
DIABETIC RETINOPATHY, DIABETIC RETINOPATHY, BLINDNESS, DIABETIC RETINOPATHY, COMPLICATION, RETINA, PROLIFERATIVE DIABETIC RETINOPATHY, MACULAR EDEMA, EYE, DIABETES
Diabetic retinopathy (DR) is a complication of diabetes damaging the retinal vessels that can lead to blindness if left untreated [The worldwide prevalence of Diabetic Retinopathy (DR) was found to be 34.6% [DR is an emerging cause of blindness in developing countries like Nepal. SK Mishra et al. showed that 10% of the people with diabetes had some form of DR in Nepal. The prevalence of Non-proliferative Diabetic Retinopathy, Proliferative Diabetic Retinopathy, and complete vision loss due to macular edema was found to be 9.1%, 0.5%, and 0.3% respectively in Nepal [Our organization, Reiyukai Eiko Masunaga Eye Hospital (REMEH) is a non-profitable community-based hospital in Banepa, Nepal providing eye care services to a population of 411,057 in the Kavrepalanchowk district. In 2019, the hospital launched the retina clinic and started retinal services. Since the uptake of DR screening did not increase as expected, we conducted a problem tree analysis and identified that lack of referral system is one of the major reasons for the low uptake of DR screening at our hospital. Scheer Memorial Hospital is a multispeciality hospital about 2 km distance to Reiyukai Eiko Masunaga Eye Hospital. It has no eye department but has been running a regular diabetic clinic. This is a site for referring diabetic patients for DR screening. We identified that creating referral pathway between Scheer and REMEH would increase the uptake of diabetic retinopathy. Similarly, Piyasena et al. identified that the lack of knowledge and awareness on DR, and zero awareness of the importance of regular DR screening and follow-up, combined with poor information on referral pathways were key elements to be improved for better uptake of DR in the context of Sri Lanka [Published studies on referral pathways in Nepal are scarce. The aim was to investigate the effectiveness/ impact of providing health education intervention to selected health personnel and establishing a referral pathway on the attendance of patients with DM for retinal screening at REMEH. This was a pilot study as no such study was previously conducted in Nepal.