BMJ 1996;312:1362 (25 May)

Letters

Screening for diabetic retinopathy

EDITOR,--J M Mason and colleagues state that the performance of high street optometrists in the Department of Health's study of screening for diabetic retinopathy was poorer than that of general practitioners and that this is surprising.1 A tabulation that I have done of the results from that and other studies shows that the rate of detection of sight threatening diabetic retinopathy by high street optometrists and general practitioners when they use direct ophthalmoscopy alone is similar: the rate for general practitioners was 52% in one study and 55% in another, and that for optometrists 48%--that is, both groups miss about half of the cases.2 As other studies in the tabulation show that even ophthalmologists, when allowed only direct ophthalmoscopy, have detection rates of only 64% and 65%, the main problem is shown to be not with the screeners but with the method used--direct ophthalmoscopy.

Mason and colleagues refer to recent . . . [Full text of this article]


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