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PAPERS: Marilyn James, David A Turner, Deborah M Broadbent, Jiten Vora, and Simon P Harding Cost effectiveness analysis of screening for sight threatening diabetic eye disease BMJ 2000; 320: 1627-1631 [Abstract] [Full text]

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Sight may be threatened by more than just retinopathy

Matthew Cohen   (16 June 2000)

Sight may be threatened by more than just retinopathy 16 June 2000
Matthew Cohen, Director Medical Services International Diabetes Institute, Melbourne, Australia Send response to journal: Re: Sight may be threatened by more than just retinopathy	The strategy of using photography rather than direct examination assumes that it is only diabetic retinopathy that needs to be screened for in people with diabetes. Focussing on diabetic retinopathy ignores the fact that other ocular problems, particularly glaucoma and cataracts are common and treatable causes of visual loss. Other recommended screening programs eg for glaucoma, require direct examination,and would need to be superimposed on any photographic method. Unfortunately, this makes any discussion of the cost-effectiveness of an alternate to direct examination rather academic. In the real world of patient care, there is no satisfactory alternative to regular direct ocular examination for the full range of problems that may occur.