[Ophthalmic disease in diabetes mellitus: management from primary health care].
OBJECTIVE
To study the feasibility of a basic ophthalmological examination for the eye disease in diabetic patients by Primary Health Care (PHC).


METHODS
A multi-centre prospective study. A sample of 712 type 2 diabetics.


METHODS
Visual acuity examination, intraocular pressure measurement and the eye fundus photograph with a non-mydriatic camera taken by an optometrist. The interpretation and subsequent referral to an ophthalmology department by ophthalmologists and general practitioners (GP).


RESULTS
Visual acuity deficiency: GP, 43.7%; ophthalmologist, 36.1%; concordance, 70%; glaucoma suspicion: GP, 8.8%; ophthalmologist, 7.6%; concordance, 94%; diabetic retinopathy: GP, 28.2%; ophthalmologist, 13.4%; concordance, 78%. Ophthalmology Department referral: GP, 56.8%; ophthalmologist, 41.3% (P=0.001).


CONCLUSIONS
Agreement between GP and ophthalmologist leads to a reliable ophthalmological examination of the diabetic patient in PHC. Despite an over-diagnosis and 16% of non-justified referrals by the GP, Ophthalmology Department referral is avoided in almost half of the diabetic patients.
Sender Palacios
María José
MJ
CAP Terrassa Nord, Consorci Sanitari de Terrassa, Barcelona, Spain. mjsender@cst.cat
Vernet Vernet
María
M
Maseras Bové
Miguel
M
Salvador Playà
Antoni
A
Pascual Batlle
Laia
L
Ondategui Parra
Juan Carlos
JC
Jovell Fernández
Esther
E
D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis*; D005128:Eye Diseases / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care; D011446:Prospective Studies