"Medicaid patients are rarely screened and are at risk of becoming blind," said Ramon Velez, M.D., M. Sc., the principal investigator. Diabetes is the leading cause of preventable blindness in the United States and Velez said the study will determine if early referral to ophthalmologists will help.
The project "I See in NC" is being pilot-tested at Downtown Health Plaza of Baptist Hospital, where Velez is medical director, and then will be offered to two rural networks of Community Care of North Carolina. One is Central Piedmont Access II, the other is Access III of the Lower Cape Fear. About 2,000 Medicaid adults with diabetes will be asked to participate.
The other networks of Community Care will get the usual treatment, and Velez and his colleagues will determine whether the screening indeed reduces blindness among patients with diabetic retinopathy because ophthalmologists can act early. Diabetes can lead to changes in blood vessels in the retina called diabetic retinopathy.
Digital photography is the key to the proposal. Trained nurses will take retinal photographs using a special digital camera, and the digital images will be transmitted over the Internet and read at a new screening center at Wake Forest University School of Medicine, Velez said.
The project is being supported by a $465,034 grant from the Duke Endowment to establish the reading center; a $456,203 grant from the Kate B. Reynolds Charitable Trust will pay for the screening in the two networks, and the North Carolina Rural Health Foundation will pay for evaluation.
Velez said Medicaid data would be used to follow the patient outcomes in both the screening group and in the controls.