By Helen Carter
One in every two Australians with diabetes, or about 830,000 people, is not having their recommended eye checks, statistics reveal.
A new report found that only half of people with diabetes undergo the recommended two-yearly eye examination. It also estimated that more than 9,000 people are unaware that they have diabetic macular oedema (DME) because they are not having retinal examinations.
The report, The economic impact of diabetic macular oedema in Australia, estimates that 72,000 of more than 1.7 million Australians with diabetes have DME.
The report forecasts a blow-out over the next 15 years in diabetes and DME, predicting a 42 per cent increase. By 2030, an estimated 2.45 million Australians will have diabetes and an estimated 102,000 of those will have DME, it states.
According to the report, 280 Australians developed diabetes every day, and the productivity of Australia’s workforce was being hit hard by DME due to people of working age being affected and DME being a leading cause of blindness for working-age Australians.
It estimates that indirect financial and well-being costs associated with DME will top $2 billion this year, including decreased employment and absenteeism from poor vision, and 218 premature deaths.
The report was prepared by Deloitte Access Economics, commissioned and funded by Bayer Australia, and supported by Macular Disease Foundation Australia and Diabetes Australia.
It quotes a review, published this year in Ophthalmic Epidemiology, which found that a median of 48 per cent of people with diabetes mellitus had not undergone retinal examination within the recommended time frame—every two years for those without diabetic retinopathy or other risk factors, annually for indigenous Australians, or more frequently for high-risk groups.
‘This suggests that of the 1.73 million people with diabetes in 2015 in Australia, an estimated 830,000 people may not currently undertake retinal examinations as recommended by the NHMRC guidelines,’ report author Lynne Pezzullo said.
‘A subset of these people might have DME and could have received effective management if detected earlier through routine screening rather than being detected at a later time-point, possibly with more severe diabetic eye disease and often a worse treatment outcome.’
Report author Lynne Pezzullo
The report said an additional 9,179 cases of DME could potentially be detected in 2015 if retinal examination were provided to all people with diabetes currently not being screened.
Macular Disease Foundation Australia CEO Julie Heraghty and Diabetes Australia CEO Professor Greg Johnson said in the report: ‘It is estimated that at least 50 per cent of people with diabetes do not access regular eye tests according to national guidelines.’
Ms Heraghty said this finding was ‘worse than we thought’.
They called in the report for national action to support early diagnosis and improve the continuum of care, including a national co-ordinated approach to testing.
‘Many Australians with diabetes don’t recognise they are at risk of blindness or the importance of maintaining regular eye tests when their risk actually increases over time even if managing their diabetes well,’ Ms Heraghty said in a media release.
‘Of concern is that only half undergo the recommended two-yearly eye examination—or more frequently for some people—even though early detection and timely treatment can prevent vision loss.’
The report says early detection and treatment could reduce the economic burden, and access to anti-VEGF treatment for eligible people with DME vision impairment could save $353 million in non-health-care costs associated with vision loss and well-being in 2015.
‘If we raise awareness people will know DME can be prevented through early detection and timely treatment,’ Ms Heraghty said.
‘So many were unaware they could go blind from diabetes. In most cases, DME is preventable with early detection and timely treatment. We have to get people with diabetes to take responsibility and call their optometrist to arrange an eye check.
‘People should have an eye test on diagnosis then every two years onwards unless there are changes in vision, they are high risk or are advised by an eye-care professional to have more regular checks.’
Optometry Australia is working with Vision 2020 and Diabetes Australia on better use of the National Diabetes Services Scheme to ensure patients with diabetes are accessing regular eye care.