Optometrist Develops Diabetic Retinopathy Screening Programme

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Dr Zaheera Abdool, who graduated with a PhD in Optometry, developed a diabetic retinopathy (DR) screening programme, which is an important component in eliminating avoidable blindness and vision impairment (VI).

Supervised by Professor Kovin Naidoo and co-supervised by Doctor Linda Visser, Abdool’s study was titled, The Development, Implementation and Evaluation of a Team Approach to Managing Diabetes Mellitus (DM) and Diabetic Eye Disease in a District Health System.

The research aimed to develop and implement a DR screening model with a team of healthcare practitioners at various levels in the district health system in Limpopo province to holistically manage DM and DR, and to effectively implement existing guidelines.

‘Diabetes mellitus is a major global public health challenge with many potential systemic and ocular and /or visual complications,’ said Abdool.

‘These complications vary in severity, and can sometimes be life-threatening especially where co-morbidities such as hypertension, kidney or liver disease are also present.’

The focus of the screening programme was identifying and grading changes in the eye due to DM. Some of these changes are retinal, and early identification and treatment of DR is essential to avoid or limit VI.

According to Abdool, the health sector in Limpopo has a shortage of medical practitioners, especially endocrinologists, ophthalmologists and optometrists that are required for effective identification and management and treatment for DM and DR. ‘Methods to improve early identification of the sight or life-threatening conditions associated with DM are thus vital,’ she said.

The research involved three phases. In Phase 1, a model for management of DR was proposed and with a modified Delphi technique expert opinion was obtained from endocrinologists, ophthalmologists and medical officers (MOs) in ophthalmology to improve and refine the model. In Phase 2, the competency levels of various healthcare practitioners were explored in terms of the clinical procedures required for the model to function properly. In Phase 3 the model was implemented among a sample of patients with DM and surveys were conducted among patients and healthcare practitioners to evaluate the model and identify areas of concern.

‘The model could be implemented in other regions of South Africa and the world, and could improve healthcare in relation to DM and its management. The economic costs to society and personal costs to patients relating to VI or blindness and other DM disabilities could be reduced with the improvements in public and private healthcare that this model proposed,’ she said.

Abdool is currently Head of the Department of Optometry at Voortrekker District Hospital in Limpopo. She has been actively involved in writing and reviewing journal articles and recently submitted three articles related to her PhD findings, all of which were accepted for publication.

‘My current plan is to work on strengthening the referral protocols of patients referred from clinics for the management of ocular complications. Due to the shortage of ophthalmic nurses in the province, I also intend to initiate training programmes for primary healthcare nurses in the district for the management of anterior segment eye complications. This will assist in reducing the workload for optometrists, given their scarcity in the public sector,’ said Abdool.

Abdool lives in Mokopane, a small town in Limpopo with her six-year-old son and husband. She has three siblings who are also medical professionals. ‘Coming from humble beginnings, we were indeed blessed to have parents who taught us to “dance in the rain,” “reach for the stars” and “sparkle amongst them.”’

Words: Nombuso Dlamini

Photograph: Supplied