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IHS-Joslin Vision Network Teleophthalmology Program
Preventing Diabetes-Related Blindness in American Indians and Alaska Natives
Diabetes is the leading cause of blindness among working age adults, even though an effective treatment has been available for almost four decades. American Indians and Alaska Natives (AI/AN) have the highest prevalence rate of diabetes in the United States, more than twice the rate of the general population. Over time, diabetes causes damage to blood vessels in the eyes in a condition called diabetic retinopathy. The damage to the blood vessels can sometimes grow to dangerous levels causing moderate or severe vision loss. People with diabetic retinopathy usually do not experience visual symptoms until it is too late and vision loss has irreparably set in. American Indians and Alaska Natives (AI/AN) with diabetes are at increased risk for diabetes-related vision loss, largely because only half get the annual diabetic eye exam needed for timely diagnosis and treatment. Blindness is a particularly devastating but preventable complication of diabetes.
The Indian Health Service-Joslin Vision Network (IHS-JVN) Teleophthalmology Program was established in 2000 to use telemedicine technology to provide high quality, cost-effective annual diabetic eye exams to AI/AN. This technology obtains retinal images of patients with diabetes in the primary care clinic where they receive their usual diabetes care. The images are immediately sent to a reading center where doctors interpret the images and report on any abnormalities needing further evaluation and possible treatment. Over 70,000 retinal exams have been conducted on AI/AN patients across the nation, and this program has proven its ability to decrease diabetes related vision loss and blindness in AI/AN through improved compliance with standards of care.