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<blockquote data-quote="Dark Horse" data-source="post: 2327889" data-attributes="member: 52527"><p>There are pros and cons of each method:-</p><p></p><p>The advantage of the slit lamp examination with a bright light looks is that it looks at the whole of the retina whereas the photography screening only covers some of the retina (including the macula and the disc). </p><p></p><p>The advantages of photography screening include:-</p><ol> <li data-xf-list-type="ol">It's better at picking up changes early (small changes can be identified on photographs that would be completely missed during slit lamp examination)</li> <li data-xf-list-type="ol">All diabetic retinopathy image graders have a specific qualification in detecting and grading diabetic retinopathy. (Some opticians do elect to do this training but most do not have this level of knowledge.)</li> <li data-xf-list-type="ol">Use of photography allows good quality assurance - all positive tests are agreed by at least one other person while negative results are sampled for re-testing to make sure individuals are not missing retinopathy. If there are any queries, the photographs can be shown to the consultant ophthalmologist associated with the screening programme. (With a slit lamp examination, the examiner works in isolation and mistakes would not automatically be detected.)</li> <li data-xf-list-type="ol">Photographs are stored and can be compared from year to year. This enables comparisons to identify whether something is a worrying new change or a long-term feature which does not need further investigation. This avoids both over- and under-referral to ophthalmology.</li> <li data-xf-list-type="ol">There are automatic referral pathways in place in the screening service so that if worrying retinopathy is detected, the patient is automatically referred to ophthalmology where further examinations take place including a slit lamp examination of the whole of the retina. This gives the best of both worlds.</li> <li data-xf-list-type="ol">Photography screening is cheaper than slit lamp examinations so patients can be screened more frequently.</li> <li data-xf-list-type="ol">Photography screening is free at the point of care.</li> </ol></blockquote><p></p>
[QUOTE="Dark Horse, post: 2327889, member: 52527"] There are pros and cons of each method:- The advantage of the slit lamp examination with a bright light looks is that it looks at the whole of the retina whereas the photography screening only covers some of the retina (including the macula and the disc). The advantages of photography screening include:- [LIST=1] [*]It's better at picking up changes early (small changes can be identified on photographs that would be completely missed during slit lamp examination) [*]All diabetic retinopathy image graders have a specific qualification in detecting and grading diabetic retinopathy. (Some opticians do elect to do this training but most do not have this level of knowledge.) [*]Use of photography allows good quality assurance - all positive tests are agreed by at least one other person while negative results are sampled for re-testing to make sure individuals are not missing retinopathy. If there are any queries, the photographs can be shown to the consultant ophthalmologist associated with the screening programme. (With a slit lamp examination, the examiner works in isolation and mistakes would not automatically be detected.) [*]Photographs are stored and can be compared from year to year. This enables comparisons to identify whether something is a worrying new change or a long-term feature which does not need further investigation. This avoids both over- and under-referral to ophthalmology. [*]There are automatic referral pathways in place in the screening service so that if worrying retinopathy is detected, the patient is automatically referred to ophthalmology where further examinations take place including a slit lamp examination of the whole of the retina. This gives the best of both worlds. [*]Photography screening is cheaper than slit lamp examinations so patients can be screened more frequently. [*]Photography screening is free at the point of care. [/LIST] [/QUOTE]
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