Annual Diabetic Eye Exams in a Rural Population: An Evaluation of Primary Care Screening Adherence and Clinical Markers
Abstract
The American Academy of Ophthalmology (AAO) recommends annual screening for diabetic retinopathy (DR) for all patients with diabetes mellitus, yet only about 60% of patients receive their annual exam. This gap is critical, as diabetes remains the “leading cause of visual impairment in working-age adults worldwide.” This study follows a cohort of patients identified in 2022 (n=250) who had not received a diabetic eye exam the previous year. We focused on utilization of the Retinavue device by the ETSU Internal Medicine (IM) clinic, the influence of comorbidities, and frequency of eye exams. Chart review was performed; 67 patients were either no longer following with the practice, had no records, or were not diabetic. Descriptive statistics were collected on 183 patients including 2024/2025 eye exam results, Retinavue usage, and provider-specific adherence. Patients were categorized into three cohorts based on the number of comorbidities: patients with 0–3, 4–6, and 7–10 comorbidities. Single-factor ANOVA compared clinical variables across groups, while 2-sample T-tests compared clinical variables and intervals between exams of DR-positive and DR-negative patients. ANOVA results showed significant differences in serum Cr (p=0.0011) and days since the last IM visit (p=0.023). T-test comparisons revealed significant differences in HBA1c (p =0.013) between DR groups. In this cohort, 44 patients had an eye exam during the one-year period ending in March 2024 and 34 patients had an eye exam during the one-year period ending in March 2025. Prioritizing annual eye exams is still important amongst these 183 patients. We found that 17% of up-to-date patients had eye exams using Retinavue. Care models focusing on renal and A1C monitoring provide the best opportunity to bridge the screening gap for vulnerable populations through point-of-care Retinavue within the ETSU IM clinic.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
23
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Brent Aebi
Annual Diabetic Eye Exams in a Rural Population: An Evaluation of Primary Care Screening Adherence and Clinical Markers
Culp Ballroom 316
The American Academy of Ophthalmology (AAO) recommends annual screening for diabetic retinopathy (DR) for all patients with diabetes mellitus, yet only about 60% of patients receive their annual exam. This gap is critical, as diabetes remains the “leading cause of visual impairment in working-age adults worldwide.” This study follows a cohort of patients identified in 2022 (n=250) who had not received a diabetic eye exam the previous year. We focused on utilization of the Retinavue device by the ETSU Internal Medicine (IM) clinic, the influence of comorbidities, and frequency of eye exams. Chart review was performed; 67 patients were either no longer following with the practice, had no records, or were not diabetic. Descriptive statistics were collected on 183 patients including 2024/2025 eye exam results, Retinavue usage, and provider-specific adherence. Patients were categorized into three cohorts based on the number of comorbidities: patients with 0–3, 4–6, and 7–10 comorbidities. Single-factor ANOVA compared clinical variables across groups, while 2-sample T-tests compared clinical variables and intervals between exams of DR-positive and DR-negative patients. ANOVA results showed significant differences in serum Cr (p=0.0011) and days since the last IM visit (p=0.023). T-test comparisons revealed significant differences in HBA1c (p =0.013) between DR groups. In this cohort, 44 patients had an eye exam during the one-year period ending in March 2024 and 34 patients had an eye exam during the one-year period ending in March 2025. Prioritizing annual eye exams is still important amongst these 183 patients. We found that 17% of up-to-date patients had eye exams using Retinavue. Care models focusing on renal and A1C monitoring provide the best opportunity to bridge the screening gap for vulnerable populations through point-of-care Retinavue within the ETSU IM clinic.
