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Dorset Diabetic Eye Screening Programme 2010 Update

Dorset Diabetic Eye Screening Programme 2010 Update. Dr Wendy Gatling Clinical Director DDESP. DDESP 2010 Update. Annual Statistics Ungradeable & pupil dilatation Current Referral Pathway Web based Grading Exercise SLB & SLEs. DDESP Structure March 2010.

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Dorset Diabetic Eye Screening Programme 2010 Update

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  1. Dorset Diabetic Eye Screening Programme2010 Update Dr Wendy Gatling Clinical Director DDESP

  2. DDESP 2010 Update • Annual Statistics • Ungradeable & pupil dilatation • Current Referral Pathway • Web based Grading Exercise • SLB & SLEs

  3. DDESP Structure March 2010 • 45 optical practices (29 offer SLB) • Swanage + DCH hospital clinics • RBH + PHT monitoring clinics • Grading: 44 optometrists (4 on leave+1 suspended+3 due to stop end March) + 4 hospital graders • Capture only:12 screeners (1suspended)

  4. DDESP 7.9.09 Snapshot Sept 09 Dec 09 Programme size 28,504 (33,505) Eligible for screening 25,468 (29,957) Excluded 425 (1.5%) Opted out 133 (0.5%) Community SLB 1198 Hospital SLB 196 Ophthalmology 2,065 (7.2%) April 2010 EQA review standard >2% excluded considered unsafe

  5. Annual Report 2008/9 • Digital screening 22,599 patients [26,006 tests] • SLB examinations 1,496 by optometrists • Attended screening ~ 89% Optical Practice Activity(from Orion payments) Capture 21,838 Grading 20,252 Concurrent SLB 1,273 ** Separate SLB 223

  6. Grading Results • Proliferative R3 237 patients • Pre-proliferative R2 183 patients • Maculopathy M1 840 patients • Required SLB 528 patients • Referred to ophthalmology 293 patients in 6 months [projected 586 for 1 year]

  7. Prevalence of any retinopathy Annual Report 08/09 All images graded 23,494 Any retinopathy detected 7,283 (31%)

  8. Prevalence of any retinopathy April-Dec 09 33%

  9. Ungradeable Rate Orion report 2008/9 213 unassessable 1070 unobtainable Total 4.4% Orion report April-Dec 09 325 unassesable 941 unobtainable Total 6.5%

  10. How to Use Orion for SLB grading

  11. Reducing Ungradeable Images New pupil dilation protocol 1% tropicamide 1 drop each eye Repeat after 15 minutes Inadequate dilation at 30 minutes 2.5% phenylephrine [STOCK ITEM] Patient notes – use 2 mydriatics

  12. DDESP Referral Pathway • All patients with any retinopathy or unassessable go to second disease grade • All R2, R3 or M1 potentially referable to MDT • New protocols for R3.2 or R3.3 • New protocol for M1 with reduced VA and dots or haemorrhages only

  13. DDESP weekly MDTs

  14. Patients Treated for DR Screening to treatment time audit Oct 08-March 09 67 patients All patients treated by laser April 08 to March 09 RBH & PHT 198 Oct 08 to March 09 RBH, PHT & DCH 238 NB Estimate 23% of patients receiving laser come after first HES from DDESP

  15. Web based Grading Exerciseending Dec 2009 • 42 of 43 eligible graders and 1 capture technician participated • Good results overall • 20 graders suggested grading session – individual and group sessions NEXT EXERCISE OPEN • 50 imagesets by end of May 2010

  16. DDESP & EQA grading testsnew targets

  17. National EQA test sets DDESP 53 graders 31% logged on New feature Welcome to the online EQA system View history

  18. SLB & SLEs in DDESP Barriers to Implementation: target April 2011 Pilot group of 7 optometrists to ‘train’ & become accredited SLE at PHT JRC Second group of 3-5 optometrists in Autumn 2010

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