BACKGROUND
Mobility challenges, transportation, and finances may serve as barriers to diabetic retinopathy (DR) screening in the growing elderly population in Ontario. Screening of patients in their own nursing homes using teleophthalmology may improve accessibility to DR screening.
OBJECTIVE
To report the feasibility, results, and patient satisfaction of a pilot expansion of the Toronto Tele-Retinal Screening Program in an elderly long-term care home.
METHODS
A pilot project was initiated with a cohort of elderly patients with Type II diabetes mellitus (DM) in long-term care who were referred to the Toronto Tele-Retinal Screening Program for DR screening between April 1, 2022 and July 1, 2022.
RESULTS
A total of 28 patients were screened for DR. Half (14/28) of patients suffered from a fall within the last year and 35% (10/28) were fully dependent for mobility. Overall, 14.3% (4/28) of patients could not be successfully imaged. Of the patients imaged, 8.3% (2/24) were advised to arrange an urgent follow-up. Pathologies identified included uncontrolled glaucoma (4.1%, 1/24), non-proliferative DR (NPDR) (8.3%, 2/24), wet age-related macular degeneration (AMD) (8.3%, 2/24), and dry AMD (37.5%, 9/24). A total of 20.8% (5/24) patients could not undergo tabletop imaging due to mobility issues. Screening of 60% (3/5) of these patients were successful with the handheld camera. Overall, 90% (17/19) of patients rated their subjective screening experience as either “brilliant” or “really good.”
CONCLUSIONS
This pilot project demonstrated that the implementation of the Toronto Tele-Retinal Screening Program into elderly long-term care homes may mitigate common barriers to eye screening with a good subjective patient experience.