Tayyab Afghani, Khalid Saeed Ahmad Chaudhry, Nadeem Qureshi.
Screening for Diabetic Retinopathy: a hospital based study of paying and non-paying patients.
Pak Armed Forces Med J Jan ;56(2):173-81.

Purpose of Study: A descriptive study was carried out to determine that results of screening for diabetes and diabetic retinopathy amongst the paying and free hospital patients. Setting: Tertiary eye care hospital Methodology: A total of 25,510 people over 40 years were screened for diabetes in an eye hospital setting. Initial screening was carried out by urine dipstick followed by random blood sugar examination. A value >= 140 mg/dl of blood sugar was considered positive for diabetes. All the diabetics were then examined for any evidence of diabetic retinopathy through indirect ophthalmoscopy in a dilated pupil by a midlevel ophthalmologist. Health education campaign at public, patient and professional level was also conducted. Main Outcome Measures: Prevalence of diabetes and diabetic retinopathy amongst paying and non-paying hospital patients. Results: The results of screening were analyzed for two distinct groups: hospital based free patients (poor urban population) and hospital based paying patients (affluent urban population). The prevalence of diabetes was found to be 10.34% and 18.57% in poor urban and affluent urban groups respectively. The prevalence of diabetic retinopathy in the total screened population in these two subgroups was 2.52% and 4.42% respectively, while this prevalence in the diabetic population was 24.39% and 23.80% respectively. Conclusion: It was observed that the prevalence of diabetic retinopathy was two times more in the affluent urban population as compared to poor urban population. For each known diabetic, there were three previously undiscovered diabetics in urban/hospital based population.

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