Journal Articles

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Swansea University: Blindness from diabetes halves in Wales, new research shows

The number of people in Wales diagnosed as blind or living with sight loss as a result of diabetes has almost halved since the introduction of a new national diabetic retinopathy screening programme in 2003, according to new research published in the British Medical Journal.

The research, conducted by the Diabetic Research Unit at Swansea University, analysed new certifications for sight loss, and blindness in Wales due to diabetic eye disease between 2007 and 2015.

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Jama Opthamology: Association of Repeated Intravitreous Bevacizumab Injections With Risk for Glaucoma Surgery

In this case-control study of 74 patients who underwent glaucoma surgery and 740 control participants, the adjusted rate ratio for glaucoma surgery was higher for patients who received 7 or more intravitreous bevacizumab injections per year than for those who received 3 or fewer intravitreous bevacizumab injections per year.

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The National Academies Press: Making Eye Health a Population Health Imperative: Vision for Tomorrow

The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult’s risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child’s social development, academic achievement, and better health across the lifespan.

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Community Eye Health Journal: Field testing project to pilot World Health Organization global eye health indicators in Latin America: lessons learned thus far

A project is underway in Latin America to strengthen the collection and reporting of eye health indicators in collaboration with ministries of health, national VISION 2020 or prevention of blindness committees, and national professional societies in five countries: Chile, Honduras, Mexico, Peru, and Uruguay. Secondary objectives include evaluating the feasibility of accurate data collection, the reliability of the indicators, and the adequacy of the metrics used to define the indicators, as well as barriers to obtaining these data.

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Diabetes Care: Diabetic Retinopathy: A Position Statement by the American Diabetes Association

Diabetic retinopathy diagnostic assessment and treatment options have improved dramatically since the 2002 American Diabetes Association Position Statement. These improvements include the widespread adoption of optical coherence tomography to assess retinal thickness and intraretinal pathology and wide-field fundus photography to reveal clinically silent microvascular lesions. Treatment of diabetic macular edema is now achieved by intravitreous injection of anti–vascular endothelial growth factor agents, and the same drugs are now used for proliferative diabetic retinopathy. Improvements in medications and devices for the systemic therapy of diabetes have also improved the ability of patients to optimize their metabolic control.

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Public Health England: Diabetes Eye Screening: Competencies for Administrative Staff

Public Health England has released a new report to guide diabetic eye screening providers in developing local frameworks for training administrative staff.  The report contains a list of competencies, assessment criteria, indicative content, and links to further resources and appropriate documents.

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Community Journal of Eye Health: The Diabetes Epidemic and its Implications for Eye Health

Diabetic retinopathy (DR) is caused by damage to retinal blood vessels. It is estimated that one third of people with diabetes have DR, and that up to a third of them have impaired vision. Although advanced DR can lead to blindness, the early stages are entirely asymptomatic. It is therefore essential that everyone with diabetes has their eyes examined for DR, ideally every year.

Nearly half of all people with diabetes don’t know they have the condition, so the damage to their eyes progresses to an advanced stage before there is an opportunity to prevent vision loss. This is tragic, as the risk of developing DR and vision loss can be reduced by keeping blood glucose, cholesterol and blood pressure as near normal levels as possible.

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Diabetes Spectrum: Special Considerations in Older Adults With Diabetes – Meeting the Challenge

Modern diabetes care systems for older people require integrated care between general practitioners, hospital specialists (diabetologists and geriatricians), and other members of the health care team. This should have a multidimensional approach with an emphasis on prevention of diabetes and its complications; early intervention for vascular disease; assessment of disability because of limb problems; assessment of other geriatric syndromes, eye disease, and stroke; and an overall strategy to promote well-being and normal life expectancy.

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UpToDate: Treatment of Type 2 Diabetes Mellitus in the Older Patient

Regular eye examinations are extremely important for older diabetic patients because poor vision can lead to social isolation, an increased risk of accidents, and impaired ability to measure blood glucose and draw up insulin doses. A complete ophthalmologic examination should be performed by a qualified ophthalmologist or optometrist at the time of diagnosis and at least yearly thereafter.

The purpose is to screen not only for diabetic retinopathy but also for cataracts and glaucoma, which are more common in older diabetic compared with nondiabetic subjects. Cataracts are over twice as common in people over age 65 years with diabetes compared with similarly-aged nondiabetic subjects (38.4 percent versus 16.6 percent), while glaucoma is almost three times more common (11.2 percent versus 3.8 percent).