A team approach to diabetes-related eye disease
Diabetes is a serious issue of our times and it registered a dramatic increase over the past thirty years. Diabetes related eye-diseases like diabetic retinopathy are important causes of blindness. As a systemic disease, diabetes should be treated with a multidisciplinary approach, involving several healthcare professionals in both primary care and specialist settings. In the UK the NHS has an yearly eye screening programme dedicated to diabetes patients which aims at reducing the risk of sight loss by early detection and treatment, if needed, of diabetic retinopathy and maculopathy. Screening is part of an integrated care system with multiple treatment goals. In the following videos, you will hear members of a typical multidisciplinary team involved in the care of diabetes patients speak about their roles and responsibilities within and outside the programme in order to provide the diabetes patients with the best care they need.
Iveta Olejkova, introduces the topic:
Tunde Peto speaks about the increasing prevalence of diabetes and diabetes related eye-diseases and how the Diabetic Eye Screening Programme was created for the prevention, early recognition and management of ocular complications in diabetes patients. Professor Peto also explains how the multidisciplinary team approach works, the benefits for the patients and the importance of adopting this kind of programme in a national health system.
General Practitioner (GP)
Sandra Isibor is a general practitioner (GP). She deals with the primary care of patients and is the one who deals with the first symptoms of diabetes and prescribes the examinations, such as blood tests, feet and urine tests. She refers patients to – and closely collaborates with – secondary and tertiary care specialists, such as Diabetes Specialist Nurses (DSNs) and Endocrinologists. Within the Diabetic Eye Screening Programme she receives every year the results of the screening for her patients, monitoring the situation.
Diabetes Specialist Nurse (DSN)
Stefania Mazzola speaks about her role as Diabetes Specialist Nurse, providing support to diabetes patients in order to help them manage their conditions and avoid further complications. The DSN works in a team with GPs, Endocrinologists, Psychologists, and Retinal Eyes Screeners. She plays a crucial role in educating patients about their disease.
John Anderson speaks about his role as Endocrinologist and Diabetologist. There is an exchange of information between him and the Diabetic Eye Screening Programme about the diabetic patients they have in common. He receives the annual eye screening reports for his patients, which is received also by the GP. He is in charge of the specific examination of diabetes patients and is involved fully in the multidisciplinary approach when it comes to diabetes-related eye diseases.
Iveta Olejkova is Screening Manager of the Diabetes Eye Screening Programme of her area. She coordinates the activities of the eye screening programme, ensuring that all people eligible for screening can access the service, which means planning the capacities to meet the demand, and primarily the personnel involved that include graders, screeners and optometrists. She also communicates with hospital services, namely ophthalmology departments and all the GPs of the area, and she takes care that everything runs smoothly.
Charlotte Wallis is a Screener and Grader for the Diabetes Eye Screening Programme of her area. Once the diabetes patients receive the letter for the yearly eye screening, they are invited to the clinic where the screeners register them, ask them questions, measure visual acuity and take photographs of the patient’s retina. Then the images undergo quality evaluation and are analysed by the Graders. The results will be sent within 2 weeks directly to the GP and the patients.
Michael Foster is a Specialist Optometrist. He deals with the triage of patients and their examination, imaging and diagnosis of eye diseases. He works very closely with the Diabetic Eye Screening Programme and with ophthalmology departments. The optometrist communicates also with the GPs and diabetologists in order to make sure that they are well informed about the health status of the patients.
Adam Mapani is a nurse specialised in medical retina care. His role is to support and counsel the ophthalmic patients and educate them to better manage their diabetes-related eye diseases and conditions. Ophthalmic nurses are also involved in the decision making, clinical diagnosis and treatment: in fact, they are trained and certified to deliver intravitreal injections.
Samantha Mann is an ophthalmologist specialised in medical retina. She deals with diabetic patients whose screenings, performed by a screener or an optometrist, showed signs of diabetes-related eye disease, such as diabetic retinopathy and diabetic macular edema. Once the patients arrive in the ophthalmology department or clinic, they are checked and examined. Then the ophthalmologist will decide which treatment is best suited for them and their specific condition, including intravitreal injections according to protocols, or photocoagulation.