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Mobilevan
WHO states that 2% of Indians are diabetic and has projected 57.5 million diabetic patients by 2025. However, recent studies done in India show that it is between 5-10%. Around a quarter of these will be affected by diabetic retinopathy. But the real problem is that diabetic patients are not aware that diabetes affects their eyes. Many physicians refer cases at a very advanced stage to tertiary centres when nothing can be done. This is mainly due to the lacunae in awareness on the available treatment modalities. In addition, there is no proven service delivery model for diabetic retinopathy.
Relevant Information for diabetic patients
- Diabetics are twice as likely to develop eye problems as non-diabetics.
- The risk of blindness is 25 times higher in diabetics.
- The most common eye complication is diabetic retinopathy, involving the blood vessels of the retina.
- The onset of diabetic retinopathy is related to duration of diabetes.
- Diabetic retinopathy is often symptomless until deterioration of vision occurs.
- Early detection and laser treatment for diabetic retinopathy significantly reduce risk of vision loss.
- All diabetics should have periodic eye examinations by an eye doctor.
Aravind Eye Hospitals and World Diabetes Foundation (WDF), Denmark have joined hands to combat diabetic retinopathy attempting to meet the need for developing a holistic model covering awareness creation, service delivery, and training for the physician and paramedical personnel to deal with problems of diabetes and diabetic retinopathy in the community. As part of the project a VSAT Mobile screening van has been specially designed to screen the diabetic patients in the camps, hospitals and clinics of diabetologists.
Advanced Eye Screening Unit – Mobile Van
Mobile Clinic has a VSAT antenna provided by Indian Space Research Organization (ISRO). This antenna can be used for voice, data transmission and Video conferencing.An ophthalmic technician takes the retinal images of the diabetic patients using a special digital fundus camera. The fundus (retinal) images are stored in a software-DRAGON (Diabetic Retinopathy Assessment & Grading Over Network) designed for this along with patients’ demographic data.Video conferencing facility is also available by which the retina specialist at the base hospital can see and talk to the patient in the van directly.This data is then transmitted to the Reading and Grading Centre at the base hospital in Madurai.
The Reading centre at the base hospital in Madurai has multiple terminals to receive the images. The Grader grades by using the special software. The software supports the grader to elicit the severity level of Diabetic Retinopathy and suggests further management. This is verified by the Retina Specialist. The diagnosis and advice will be given in a report format and sent to the van.At the van this report is printed and given to the doctor/ patient for further followup. This advanced eye screening unit will benefit the diabetic patients to get the experts opinion immediately and also the patients need not travel to the tertiary center for screening.
Physician’s Role
Physicians who are involved in providing diabetic care to their patients have a pivotal role in ensuring that their patients are screened either by ophthalmoscopy (through dilated pupils) or fundus photography. The work up of diabetes is not complete without eye examinations. The Aravind Mobile Eye Screening unit provides the facility right at the physician’s doorstep.
All that the physician needs to do is:
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Collect diabetic patients in groups on a prefixed day.
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Give patients' demography & relevant clinical data such as blood sugar level, blood pressure.
Through the mobile screening unit, patients retinal status and treatment advice will be given to the physician.
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Get the opinion and suggestions from experts.
Advantages
Patient's avoid travel
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Money and time saved
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Compliance is better as it is done at their place
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