The integration of diabetic eye screening into haemodialysis units in Northern Ireland

Background: Diabetes is rising globally and is the most common cause of both endstage renal disease and blindness. People on haemodialysis have to attend several dialysis appointments per week which can affect their attendance at diabetic eye screening. In addition, previous literature suggests patients on haemodialysis are more likely to have sight threatening diabetic eye disease.

This study aims to determine attendance at the Diabetic Eye Screening Programme in Northern Ireland, diabetic retinopathy severity and use of handheld retinal imaging in people with diabetes attending haemodialysis units in Northern Ireland.

Methods: All patients with diabetes attending haemodialysis clinics regionally were screened and graded by the Diabetic Eye Screening Programme in Northern Ireland using a handheld and/or conventional non-mydriatic fundus camera.

Results: All eligible 149 people were offered a Diabetic Eye Screening Programme
in Northern Ireland appointment, 132 attended, 33.8% of whom have not been seen in >3 years and 15% had never attended Diabetic Eye Screening Programme in Northern Ireland despite multiple previous appointments. Altogether, 12.9% required urgent referral to hospital eye services which is significantly higher than the national average of 0.4%.

Conclusions: Those on haemodialysis are at high risk for sight threatening diabetic retinopathy, implementing Diabetic Eye Screening Programme in Northern Ireland in haemodialysis clinics enables timely diagnosis and referral.