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Year : 2021  |  Volume : 69  |  Issue : 3  |  Page : 655-659

Capacity building for diabetic retinopathy screening by optometrists in India: Model description and pilot results

1 Head, Teleophthalmology, LV Prasad Eye Institute Network Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
2 Research Scholar, School of Optometry and Vision Science, The University of New South Wales, UNSW, Sydney, Australia
3 Research Scholar, Birla Institute of Technology and Sciences, Pilani, Telangana, India
4 Manager, India Vision Institute, India
5 Head – Image Reading Centre, LVPEI, India
6 Chief Executive Officer, Optometry Council of India, India
7 Director – Brien Holden Institute of Optometry and Vision Sciences and Scientist, Prof Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India

Correspondence Address:
Dr. Padmaja Kumari Rani
Head, Teleophthalmology, LV Prasad Eye Institute Network Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad – 500034
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1944_20

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Purpose: The present study's objectives are 1) to describe a novel model of Diabetic Retinopathy Capacity Building (DRCB) for optometrists in the detection of diabetes-related retinal pathology in India and 2) to assess the outcomes of this model by comparing the ability of optometrists to detect these diseases using retinal photographs, vis-à-vis, a specialist ophthalmologist. Methods: The DRCB model for optometrists conducted between August 2016 and August 2018 included training, certification in the screening, and referral guidelines for Diabetic Retinopathy (DR) and hospital-and community-based service delivery. Training included a 7-month long fellowship in DR and mentored participation as cofacilitators in 1-day orientation workshops on DR screening guidelines across India. The sensitivity and specificity of study optometrists in screening for DR by fundus photography were compared to a retina specialist before certification. Results: A total of eight optometrists successfully completed their DR fellowship in the project duration of 24 months. The sensitivity and specificity of detection of any DR were 95 and 79%, any Diabetic macular edema (DME) was 80 and 86%. The sensitivity and specificity of detection of sight threatening DR were 88 and 90% and DME was 72% and 92% respectively. Seven workshops were cofacilitated by study optometrists training 870 optometrists in DR screening guidelines across India. Conclusion: The present DRCB model results advocate for an optometry coordinated DR screening in India. Lessons learnt from this model can be useful in designing community-based task sharing initiatives for optometrists in DR screening.

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