Feasibility of an Alternative Pathway for Hospital Referrals From Diabetic Eye Screening Wales DESW for People Suspected With Sight-threatening Diabetic Eye Disease Diabetic Maculopathy FARSight-DM

What this Trial Is About

Researchers are evaluating a new care pathway for people with diabetes suspected of having diabetic maculopathy or pre-proliferative diabetic retinopathy. The study aims to see if using opticians in community practices, combined with virtual review by hospital ophthalmologists, is safe, acceptable, and efficient compared to the current hospital-based eye service. This approach could reduce hospital clinic pressures, improve patient experience, and lower costs and environmental impact. The trial compares two groups one receiving usual care with hospital eye service assessments by ophthalmologists, and the other undergoing community-based optical coherence tomography OCT imaging by trained optometrists with virtual ophthalmologist review. Participants receive one imaging visit in either setting. The study collects data on imaging results, clinical exams, and patient experiences through questionnaires and interviews. Both pathways include follow-up plans decided by ophthalmologists based on the imaging and clinical findings. Participants will be involved in a single imaging appointment and then complete a questionnaire about their experience. Some may be invited for interviews to explore their views further. Researchers will measure the time from referral to treatment, number of appointments, travel distances, costs, and patient-reported experiences. Data collection and analysis will continue for about a year, including health economic and environmental impact assessments, to understand the feasibility and acceptability of this community-based pathway.

Is Community Based Monitoring of Diabetic Maculopathy and Pre-proliferative Diabetic Retinopathy Safe?