A technology that has just been made available to the diabetics of Eeyou Istchee could help prevent the onset of diabetic-related blindness. The tele-retinopathy process will transmit retina images taken in the north to specialists so that the patient can access top-notch medical care without leaving their home community.
Patients in remote areas like the James Bay region will now access ophthalmologists who specialize in retina diseases and who are able to provide early diagnoses of any eye-related anomaly.
“The first thing to remember about tele-retinopathy is that it is important to look for changes in the retina because of how diabetes can affect the eye,” said Dr. David Dannenbaum, who works for the Cree Board of Health and Social Services of James Bay. “We can treat it before there are any real symptoms, completely preventing blindness. However, if you wait until you have symptoms, it’s too late.”
According to Johanne Desrochers, Associate Director for Telehealth Services at the McGill University Health Centre in Montreal, the new program was set up after the CBHSSJB expressed a need for better medical services. New technology makes the information exchange an easy procedure. Given the diabetes epidemic in the north, this service was a priority.
In the past, patients either saw an ophthalmologist who would travel from community to community or were flown to a community that offered the services. Not only was this a costly process, it often wasn’t practical.
“We built a program with a technological platform that is now being rolled out in each of the communities in the Cree territory. So far we have two communities where this is already started – Waskaganish and Waswanipi,” said Desrochers.
The CBHSSJB set up a program to train community health representatives (CHRs) how to take photos of the retinas and then transfer the image into a software application. The image is then sent to the specialist who either recommends treatment or monitoring. Someone will now be on hand in each community to make this simple test available when it is needed.
“This is exam requires two people – a CHR to take the picture, and a nurse who is on hand to dilate the pupil so that the picture is of better quality,” explained Desrochers.
According to Desrochers, once the image is sent to the specialist, it will be evaluated for an anomaly or changes in the retina that would require further follow-up. Sometimes this could mean urgent follow-up with an ophthalmologist or more monitoring over the coming years.
The service does not mean a reduction in face-to-face examinations. Ophthalmologists will still travel to the communities when they are needed.
This program is only available in only two regions so far, James Bay and Témiscamingue. In areas like Montreal there is still a lengthy wait to see an ophthalmologist so patients in the north are actually getting more timely service than those in the south.
At the same time, Dannenbaum stressed that patients need to know that there is a big difference between eye specialists. He often has diabetic patients who think that they have seen an ophthalmologist when in fact they were examined by an optometrist.
Dannenbaum said screening is different from seeing the doctor who comes to measure a patient’s eyes for glasses.