Factors associated with having eye examinations in persons with diabetes
S. E. Moss, R. Klein and B. E. Klein
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.
OBJECTIVES: To estimate compliance with guidelines on ocular examinations
for diabetic persons, to examine factors that affect compliance, and to
determine reasons for noncompliance. DESIGN: Cross-sectional population
study. SETTING: Primary care setting. PATIENTS: The population is 765
diabetic persons with younger onset and 533 with older onset who
participated in the 1990 to 1992 follow-up examination of the Wisconsin
Epidemiologic Study of Diabetic Retinopathy. MEASUREMENTS: A medical
history was taken in which subjects were asked about eye examinations by
ophthalmologists and optometrists. RESULTS: Sixty-four percent of the
younger-onset group and 62% of the older-onset group had had a dilated eye
examination in the previous year. Persons in both groups were more likely
to have had a dilated examination if they had a longer duration of
diabetes, more severe retinopathy, a history of glaucoma or cataract, and
health insurance that covered eye examinations. Persons with younger-onset
diabetes were more likely to have had an examination if they were older,
were visually impaired, and had more education or higher income. Persons in
the older-onset group were more likely to have had an examination if they
were female or taking insulin. In those not having an eye examination, 79%
and 71% of the younger- and older-onset groups, respectively, reported not
having had one because they had no problems with their eyes, and 31% and
35% reported not having been told they needed one. Thirty-two percent and
11% said they were too busy, and 30% and 12% said they could not afford an
examination. CONCLUSIONS: Diabetic persons should be educated as to the
need for eye care; the results show that barriers to eye care exist in the
form of affordability and lack of time.
