Diabetic Retinopathy is a serious complication of diabetes which can lead to blindness. In the Vision and Eye Research Institute (VERI) we are committed to reducing the risk of diabetes-related blindness.
South Asian communities are at a higher risk of diabetic retinopathy. The risk of blindness due to diabetic retinopathy can be reduced by good control of diabetes and uptake of regular retinal screening.
Research by Professor Pardhan (right) and her team has shown that Asian patients from the UK, Nepal, India, Thailand and China who are most at risk of blindness also have poor knowledge of how to control diabetes and do not attend regular retinal screening.
We are working with several organisations to tackle this high risk of diabetic retinopathy in different parts of the world. Working with local communities, hospitals and non-government organisations we have developed strategies to improve the control of diabetes at grassroots levels. These have been delivered through culturally appropriate diabetic training workshops, leaflets in local languages and improved clinical care by eye care professionals. We have developed culturally-appropriate training videos and awareness programmes in different languages such as Urdu, Hindi, Nepali and Chinese.
Professor Shahina Pardhan - Director, Vision and Eye Research Institute
Dr Raju Sapkota - Senior Research Fellow, Vision and Eye Research Institute
Dr Hena Wali Haque - Research Fellow, Vision and Eye Research Institute
VERI runs workshops in the UK and around the globe to improve awareness of diabetes and diabetic retinopathy.
In order to improve diabetic knowledge and awareness in the UK, we have developed diabetes awareness material, delivered through local media and community workshops. We have developed diabetic and diabetic retinopathy awareness programmes in Nepali, Urdu and Hindi.
In collaboration with various stakeholders, we have held diabetic retinopathy awareness programmes in community centres, religious festivals, mosques and community gatherings in cities that have large number of South Asian population. These include:
Further workshops planned:
Right: Professor Pardhan talking about diabetes and its eye complications to members of Pakistan Association Community of Peterborough, June 2019
"We will share this knowledge and awareness about diabetes and importance of attending retinal screening to our family members and friends who have diabetes."
Members of the Pakistan Association Community of Peterborough at VERI's workshop about diet, good control of diabetes and retinal screening uptake to reduce the risk of diabetic retinopathy, February 2020.
"I now know that I should go for eye screening."
"Please can we have some more of these sessions?"
Dr Sapkota talking to a resident about diabetes and diabetic retinopathy at an annual health camp organised by Non-Resident Nepali Association UK, May 2019.
"We were ignoring letters by doctors, but we will not ignore then now - we will have our eyes photographed on a regular basis."
"We now know that diabetes can damage our eyes silently. Therefore, we will not ignore any letters that are sent to us asking to attend diabetic eye examinations."
"We did not know that if diabetes is not controlled, the back of our eyes can bleed and our vision will be disturbed significantly."
Participants at a diabetic workshop organised by Bexley Nepali Society, London, February 2020
"We did not know that diabetes can become worse if we are stressed and that we can go blind if diabetes is bad."
"I did not know that there is a difference between having my eyes tested for spectacles and for diabetes - I know now."
To help improve awareness of diabetes and diabetic retinopathy, VERI staff have been interviewed by ITV Anglia, Salam Radio, online services (OS) Nepal.com, British Force Broadcasting Service (BFBS) Gurkha Radio and Nepali Association in the UK. These interviews, which were also broadcast on social media, have been viewed more than 25,000 times.
We have worked with a team of experts to develop patient-centred culturally appropriate training programme in Nepalese. The programme was developed around key themes, improving knowledge and awareness about diabetes, diet, physical activity, goal setting, and retinal screening. This is delivered by doctors and optometrists in all seven provinces in Nepal.
The VERI team with practitioners in Nepal
"This has led us to target those patients who are more at risk of blindness."
"This work has led to improved strategies ... we need to address the different barriers for an illiterate female compared to a younger working male."
A clinical trial is being conducted to see how training videos help to improve people's awareness about diabetes and diabetic retinopathy screening.
VERI researchers and collaborators at the Diabetes, Thyroid, and Endocrine Care Centre, Pokhara, Nepal
We are also conducting community workshops in different villages of Nepal on how to improve control of diabetes and reduce the risk of diabetic blindness in collaboration with the Nepalese Association of Optometrists.
Pratishka Chalise and Deepika Karki from VERI delivering a retinopathy awareness programme to diabetic patients in Nepal
"We did not know that diabetes can lead to blindness."
VERI researchers Dr Sapkota and Dr Upadhyaya were invited by the Lions Club of Pokhara, Nepal to mark World Diabetic Day on 14 November 2019. Informed by VERI’s recent research publication on sight-threatening retinopathy in patients most at risk, our lead collaborator in Nepal (Dr Tirtha Lal Upadhyaya) talked about the culturally-appropriate diabetic diet, exercise, lifestyle, and need for attending diabetic eye check-up to more than 100 members of the public. This was very well received by participants.
"We learnt new knowledge about diabetes by attending the event, which was presented in simple Nepali language."
"We now know that diabetes can cause blindness, so we will not neglect to go to an eye doctor for check-ups."
Right: Professor Rajiv Ramen from Sankara Nethralaya, Visiting Professor at VERI
Sankara Nethralaya Hospital has developed a bespoke one-to-one counselling service for patients with sight-threatening retinopathy to explain the importance of regular attendance and treatment.
"This has already improved attendance for retinopathy screening and reduced risk of blindness in 90% of all the patients with sight-threatening retinopathy."
Right: Nurses and patients at the VERI workshop in Darjeeling
Kurseong sub-divisional hospital use our training videos to improve awareness about diabetes and diabetic retinopathy in their patients.
"I should go to my doctor instead of traditional healers for my diabetes."
Second Affiliated Hospital in Hangzhou in the eastern region of China, serving 600,000 outpatients annually from a catchment area of greater than one million square kilometres, has developed various strategies to address the significantly high profile of diabetic blindness in patients attending the eye clinics.
"This has highlighted the lack of awareness amongst diabetic patients on how important it is to look after their diabetes."
We are collaborating with Rajavithi Hospital in Bangkok to tackle the current low levels of retinal screening uptake by diabetic patients in Thailand.
A full list of VERI publications, including on diabetes and diabetic retinopathy, can be found on our publications page.