Tony Nicholls and Christel Jenkins, 25th August 2016

Tony Nicholls and Christel Jenkins, 25th August 2016

Tony Nicholls and Christel Jenkins

N&NUH, Diabetes Eye Screening Unit

Annual eye screening for diabetic eye disease by the N&NUH’s mobile unit is now a well-established and very familiar process to most diabetics in Norfolk. Interestingly Norfolk pioneered the use of these mobile units, and they have become an essential part of diabetes care by checking for any developing retinopathy  (damage to the small blood vessels and neurons on the retina at the back of the eye) so that early treatment can be given because retinopathy is a leading cause of blindness.

Christel gave the first part of this joint presentation noting that from 1st April 2015 – 31 March 2016 they had screened 23,932 patients, the number of new patients during that time totaled 3,330 averaging 277 per month.  Since April 2016 the number of new patients being referred was approximately 400 per month.  Photographs were shown illustrating the progressive stages of retinopathy, and the treatments involved were discussed. However with the improving management of diabetes by clinicians and patients (especially through the control of blood sugars, blood pressure and cholesterol) only 1-3% of scans give rise to concern and the need for referral.

The Unit now also has the use of an OCT camera that gives a 3D image of the retina, this offers a non-invasive scan of the macula this is proving particularly helpful in the diagnosis of macular oedema (cysts or swelling in the macula).

The need to dilate pupils before screening was explained as without the drops the image of the retina is very poor and of no use in diagnosis. The effect of the drops used to expand the pupils normally lasts for around two hours, in some up to six hours, and so the use of sun glasses is recommended following scanning.

Following the upgrading of the Unit’s cameras, Tony then spoke about a new use for their two original, now 15 year old, cameras. Dr. Swe khin Myint, from Myanmar, a consultant endocrinologist at the N&NUH was keen to set up a screening service in her own country where there is a desperate need. For genetic reasons there is a much higher incidence of diabetes in Myanmar at 10-15% of the population with hitherto no screening service available.

During a short visit to Rangoon Tony had the task of unpacking the cameras (shipped in advance) and getting them operational, then training operators in under a week. That he achieved this, and the cameras still worked well after shipment, is a great testament to his abilities and the quality of the cameras. Most importantly though by bringing this technology to Rangoon a great many people’s sight will be saved and is a brilliant further use of our equipment.

The audience was greatly appreciative of these presentations, which greatly helped their further understanding of the vital importance of eye screening.