Prevalence of diabetic retinopathy and self-reported barriers to eye care among patients with diabetes in the emergency department: the diabetic retinopathy screening in the emergency department (DRS-ED) study.

This study aimed to determine the prevalence of diabetic retinopathy (DR), a vision-threatening complication of diabetes, among diabetic patients in an emergency department (ED) setting and to identify what prevents them from seeking regular eye care. Researchers conducted a cross-sectional study, recruiting 50 clinically stable diabetic patients from one ED over 29 weekdays in 2018 and 2019. They used teleophthalmology, where digital retinal images were taken without dilating drops (nonmydriatic) on site and interpreted remotely by a board-certified ophthalmologist. Results were communicated to patients' primary care physicians. Participants also completed a survey about barriers to routine eye exams and their willingness to accept interventions promoting screening. The study found that 14 patients (28%) out of 50 had DR, and for 10 of these (20% of the total group), it was a new diagnosis. Most detected cases were mild or moderate. More than half (52%) of the participants reported at least one barrier to regular eye care, with common reasons including having too many other medical appointments (12%) and the cost of an exam (10%). Encouragingly, most patients were receptive to receiving reminder phone calls (58%) or text messages (56%) to schedule a routine eye appointment. The study concludes that using digital fundus photography in the ED can effectively identify undiagnosed DR, and addressing common barriers through patient reminders could improve screening rates. However, it was a single-center study, so findings might not apply to all ED populations. Future research should assess the practicality of expanding these programs and how many patients actually follow up after screening. The 'store-and-forward' image review also means no immediate feedback.