Early screening is key to reducing diabetic retinopathy, says Surgeon

Feb 09, 2017 News

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…as GPHC benefits from training to help address challenge

Globally there are some 370 million people suffering from diabetes. Of this sizeable number many will suffer impaired vision and some will even go completely blind. The cause, according to Retinal Surgeon, John Carter, is

diabetic retinopathy.
Diabetic retinopathy, also known as diabetic eye disease, is when damage occurs to the retina due to diabetes. The retina is the third and inner coat of the eye which is a light-sensitive layer of tissue.
Dr. Carter, who practices at the Winchester Medical Centre in Virginia, United States, is currently here in Guyana lending support to the Georgetown Public Hospital Corporation (GPHC) to help address the ever increasing eyes concern linked to diabetes.
And according to him, during an interview with this publication, screening of all diabetic patients, with and without symptoms of diabetic retinopathy is the key to addressing this challenge.
“The most important thing that we want to do is make sure that all patients who have diabetes have their eyes examined even before they have symptoms. So the best option is that every patient with diabetes has an eye examination as soon as they are diagnosed,” said Dr. Carter. This, however, must be an ongoing process whereby patients are screened on an annual basis even if they do not develop symptoms.
“What we are trying to avoid is patients waiting until their vision is bad, because often when their vision is very bad they would suffer vision loss and we can’t get it back. So the treatment is most effective even before the patient notices something is wrong,” explained Dr. Carter.
He noted that although vision loss is preventable, people continue to go blind because they often seek medical attention when cases are far advanced.
“We are here to help prevent some of that blindness,” said Dr. Carter as he pointed out that the state of affairs that he has observed here was in fact what he’d anticipated.
“There is a large unmet need…I have had the privilege of working with Dr (Shailendra) Surgrim (Head of the GPHC’s Ophthalmology Department) and other colleagues, but the challenge before us is how to keep people from going blind from diabetes. We are examining what is going on and seeing how best to address the tragedy of all these people going blind when they don’t have to,” Dr. Carter asserted.
The Surgeon’s visit here comes as part of an Orbis International mission to Guyana. Orbis International is a Non-Governmental Organisation (NGO) involved in Eye Care.

Dr. Carter is part of a three-member team including Registered Nurse, Elisa Urruchi, and Technician, Ms. Kelli Wilson, who were yesterday tasked with spearheading a training session for nurses.
Dr. Carter on the other hand was yesterday engaged in a training session that catered to Ophthalmologists Celestine Hinds (who practices at GPHC and Suddie Hospitals), Rameeza McDonald (who practices at the Linden Hospital) and Damonie Lamy (who also practices at the GPHC).
All ophthalmologists in Guyana were also involved in a weekend workshop on Diabetic Retinopathy which was held February 4 and 5 last at the GPHC. Doctors were updated on the current methods of management of diabetic retinopathy and had refresher lectures on the basics of diabetic retinopathy.
The visiting team is slated to depart Guyana on Saturday but, according to Dr. Carter, he is optimistic that the collaboration between Orbis International and the GPHC will be sustained. Orbis International lends support primarily by training ophthalmologists and nurses via Hospital Based training programmes. In November of last year, Orbis facilitated a first bout of training at the GPHC for two ophthalmologists who were trained to perform laser treatment on diabetic patients.
Apart from training ophthalmologists, there was also a week-long training for nurses who underwent a workshop focusing on “Key Nursing Skills to deal with Diabetes and the Eye”. A total of 27 nurses were trained then.
Orbis has continually been contributing towards the strengthening of human resources and has committed to continued training of various eye care professionals, according to Dr. Sugrim. He disclosed that over the past two years Orbis has supported training of a Clinical Director to attend a management course in India; training of one Biomedical Technician on how to deal with eye equipment, and facilitated the attendance of four ophthalmologists to the annual American Academy of Ophthalmology Conference in the US.
Dr. Sugrim noted too that the training offered by Orbis comes as part of the Guyana Diabetes Care Project (GDCP) which is a three-year project made possible through the collaboration of Orbis, the World Diabetes Foundation, the University of Toronto, GPHC and Ministry of Public Health.
The GDCP came about after the successful completion of an initial project involving Diabetes Foot Care and according to Dr. Sugrim, the GDCP is slated to concentrate care for diabetics in two new areas – Diabetic Retinopathy (Eye Complications of the Diabetics); Diabetes in Pregnancy and Strengthening Health Information Systems in collection of Data on Diabetes in Guyana.
The establishment of the Guyana Diabetic Retinopathy Programme (a subsidiary of the Guyana Diabetes Care Project), essentially served to introduce for the first time in Guyana easy access to all diabetics to have their eyes screened for Diabetic Eye complications.
“Usually diabetics begin to have changes in their eyes and are not aware of these changes. The only method of detecting these changes in the past was an annual eye examination by an ophthalmologist,” Dr. Sugrim noted.
But with the project in place, he noted that the GPHC has been able to introduce a modern method of detecting eye complications, that is, to have digital retinal photos taken of the inside of the eye. These photos are then interpreted by highly trained eye care professionals who grade the stage of retinopathy, according to Dr. Sugrim who pointed out that patients can now book their appointments for testing through the facebook page: http://www.facebook.com/eyeguyana or by email: [email protected].
They can also walk-in to book appointments or for opportunistic screening on the same day.
This programme, which was developed by Dr. Surgim, also offers laser treatment to patients. According to Dr. Sugrim, the World Diabetes Foundation, as a major partner, has helped to procure expensive retinal cameras and ophthalmological examination instruments. The organization has also helped with the procurement of a retinal laser to treat patients who have severe diabetic eye complications.

 

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