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TeleRetina screenings give diabetic patients a clearer picture of risk for blindness

diabetes eye

By Mary Beth Schweigert

Uncontrolled diabetes is a leading cause of blindness. But unfortunately, many diabetic patients don’t get regular vision screenings or realize their sight is at risk until it’s too late.

Penn Medicine Lancaster General Health’s TeleRetina program provides a clearer picture of patients’ risk for retinopathy, which can lead to blindness if left untreated. Uncontrolled diabetes contributes to retinopathy by causing damage to blood vessels of the retina, a light-sensitive tissue that lines the eye.

Christian Hermansen, MD, medical director for LG Health Physicians Academic Region of primary care practices, said that only about half of diabetic patients nationwide follow recommendations for an annual retinopathy screening. As of 2016, just over 30 percent of LG Health Physicians’ diabetic patients were screened.

“This gap will become even more problematic, as it is estimated that one in three Americans will have diabetes by 2050,” said Hermansen, who sees patients and serves as managing physician at LG Health Physicians Family Medicine Downtown. “Many diabetic patients aren’t aware of the importance of regular vision screenings. Other barriers to screenings include transportation, time, and cost.”

LG Health Physicians aims to reduce those barriers and increase convenience for patients with the TeleRetina program, which offers quick, low-cost retinopathy screenings in the primary care office, without the need for a separate eye exam. The technology uses a special camera to take detailed images of the retina that can then be reviewed remotely by an ophthalmologist.

Following a successful pilot that began in 2017, TeleRetina screenings are now available in most of LG Health Physicians’ 34 primary care locations, as well as LG Health Physicians Diabetes & Endocrinology Specialists.

Since the project began, LG Health Physicians has increased its overall retinopathy screening rate to more than 49 percent, an improvement of 19 percent. Alarmingly, retinopathy was found in about 20 percent of the nearly 600 diabetic patients screened to date.

“Diabetic retinopathy, which represents a leading cause of adult blindness, is 90 percent treatable when detected,” Hermansen said. “We are finding a lot of issues that can potentially save our patients’ sight.”

The TeleRetina screening is ordered by an LG Health medical provider and performed by staff who are trained to take images of the patient’s eyes using high-resolution cameras that don’t require eye drops for dilation.

The screening takes no more than 10 minutes, often during a patient’s regular checkup. Ophthalmologist Michael Pavlica, MD, of Family Eye Group, Lancaster, who specializes in diagnosis and treatment of conditions of the retina, reads the images remotely and reports his findings within 24 hours.

“Retinopathy is a silent disease in its early stages,” Pavlica said. “Once a patient’s vision becomes blurry, retinopathy has already advanced, and it’s more difficult to correct.”

Nursing Supervisor Karissa Ross, RN, BSN, has screened dozens of patients at LG Health Physicians Family Medicine Susquehanna, Marietta, since early 2018. She has found that most patients are very receptive to the screenings.

“Many of our patients don’t have transportation to get to Lancaster for an eye exam,” Ross said. “They like the convenience of being able to have the screening right in our office, rather than having to make a separate appointment with an eye doctor.”

In addition to retinopathy, TeleRetina screenings have revealed other abnormal findings, such as cataracts, glaucoma or macular degeneration, in about 25 percent of LG Health patients.

“If a screening shows an abnormal result, we refer those patients to an eye doctor for treatment,” Ross said. “They are very thankful that those conditions were found and glad they had the screening done.”

If detected in its early stages, retinopathy can be monitored by an ophthalmologist, Pavlica said. Once the condition progresses, it can be treated with laser therapy or injections. It’s also especially important for diabetic patients with retinopathy to keep their diabetes under control to prevent further damage, he said.

Even if the TeleRetina screening reveals no immediate concerns, the possibility of developing retinopathy can provide a powerful incentive for patients to gain better control of their diabetes, Hermansen said.

“Finding something – or even just discussing the screening and the possible results -- can change the conversation for our patients,” he said. “It motivates them to do something about their diabetes.”


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