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    Retinal exam brings diabetic retinopathy screening to primary-care setting

    System aims to enhance low screening rates, improve access of care, increase quality outcomes

    System aims to enhance low screening rates, improve access of care, increase quality outcomes

    Take-home message: A retinal exam system improves access for patients with diabetes to detect eye disease early and refers them to an eye-care specialist for further evaluation and treatment. 

    Reviewed by Yvonne I. Chu, MD, MBA, and Sunil Gupta, MD

    It is no secret that a diabetes epidemic exists in the United States. A 2014 report from the Centers for Disease Control and Prevention states that 29.1 million Americans have diabetes—or a lsttle more than 9% of the total U.S. population. Almost one-third of those with diabetes are undiagnosed, according to the report. 

    With the possible damaging effects on the eyes, not to mention the rest of the body, it has been a challenge for eye-care professionals (ECPs) to reach those with diabetes for a recommended annual exam. Pensacola, FL-based Intelligent Retinal Imaging Systems (IRIS) is changing that by providing access for diabetic patients to complete their annual retinal exams in the primary-care physician (PCP) office.

    Related: Launch of Retina World Congress unites global thought-leaders

    The company’s retinal exam system integrates into the electronic medical record and identifies patients who need the test performed. At the primary-care office, staff uses IRIS to capture images of the patient’s eye, adding about 5 minutes on to an existing appointment. Then, the images are interpreted by an ophthalmologist or retina subspecialist.

    Sometimes, the eye specialist interpreting an image is already based in the same local area as the PCP and IRIS helps to bring them together virtually using the IRIS Cloud which stores the retina images, said Jason Crawford, IRIS chief executive officer.

    Other times, a larger health-delivery system may incorporate its own eye specialists already within their system to interpret those images, like at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami.

    More: Electroretinography detects early glaucoma signs

    Yet, a third scenario is that physicians who are part of the IRIS Reading Center will interpret the images. These readers are contracted by IRIS and provide the interpretation via the IRIS Reading Center. The Harris Health System, the public safety net for Harris County in Houston, uses this model in collaboration with the Department of Ophthalmology at Baylor College of Medicine and University of Texas-Health.

    Patients with suspicious pathology—be it diabetic retinopathy, glaucoma, cataract, or an epiretinal membrane—are guided to follow up with an ophthalmologist or retinal specialist for further care.

    “Our system reaches those patients who do not currently seek eye care and encourages them to establish care,” Crawford said.

    The ophthalmologist's role

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