In the world, there are more than 200 million people with diabetes, while in Vietnam the number is about 4.5 million people, of whom about 20% might have diabetic retinopathy at different levels. If not detected and treated early enough, it can be incurably late and lead to blindness.
Diabetic Retinopathy
Diabetic retinopathy is an eye problem that can cause blindness. It occurs when high blood sugar damages small blood vessels in the back of the eye, called the retina. All people with diabetes are at risk for this problem.
Diabetic retinopathy occurs in 90% of cases of diabetes progressing after 10-15 years, regardless of its types.
Since financial barriers and service availability remain as key challenges to most patients, Orbis and its partners have joined forces to develop an effective model that helps diabetic patients find the needed services more accessible and affordable.
Why We Concern
Currently, it’s estimated that 01 in every 20 Vietnamese adults has diabetes, who might experience severe complications including blindness due to Diabetic Retinopathy.
In a bid to meet the real needs of a great deal of patients for Diabetic Retinopathy screening, whilst most of health workers at all levels have no clinical capacity in diabetes management, the country is advised to have an effective model.
How We Approach
Orbis has applied an innovative telemedicine system which was originally developed in the United Kingdom connecting provincial endocrine units where diabetic patients visit regularly for health checks.
With a Diabetic Retinopathy grading system, it helps upload images of a patient’s retina to a server or cloud-based system for analysis by trained medical staff. Those patients found having vision-threatening conditions would be referred to eye clinics for treatment.
The model has helped to screen large volumes of diabetic patients at a relatively low cost. This is the first time the system has been applied and utilized successfully in a low-middle income country.
For the model development, Orbis provides technical training and coaching for medical staff at partner hospitals so that they can perform Diabetic Retinopathy screening and deliver laser treatments for needy patients, as well as essential equipment such as fundus cameras. Success of the pilot model would help Orbis advocate the Ministry of Health to effectively scale up Diabetic Retinopathy screening and treatment services in other localities across the country.
The system can be an answer to the key question: how to do mass Diabetic Retinopathy screening without fulltime engagement of ophthalmologists in Vietnam?
What We Have Done
- Since 2017, Orbis has supported five hospitals in Tien Giang Province and Ho Chi Minh City to screen diabetic people for Diabetic Retinopathy . With a telemedicine Diabetic Retinopathy screening system established thereat and 21 medical staff trained and mentored to provide quality Diabetic Retinopathy eye checks, a referral pathway has been created for patients with severe Diabetic Retinopathy for immediate treatment at eye hospitals;
- Knowledge of patients and medical staff on threats to vision loss due to Diabetic Retinopathy and eye-care knowhow has been improved through various communicative and educational activities;
- In 2018 alone, 17,000 people with diabetes were detected with Diabetic Retinopathy , of whom 1,000 patients were treated successfully.
What We Will Do
Expand
Expand the Diabetic Retinopathy screening system to other localities
Support
Support Vietnam to develop Diabetic Retinopathy services with laser treatment at 6 - 9 eye hospitals across the country, not just limited to a few major eye hospitals in Ho Chi Minh City and Hanoi.
Orbis will also support the Ministry of Health to standardize the training program for medical staff in Diabetic Retinopathy screening and treatment, develop national Diabetic Retinopathy management guidelines, and amend relevant health insurance policies to help all people with diabetes access eye care services to prevent vision loss, especially among vulnerable groups.