As November is Diabetic Eye Disease Awareness Month, we asked O.D.s who see several of these patients for tips on how they achieve adherence to appointments — a challenge given reported barriers, such as lack of disease knowledge, legal blindness, difficulty getting time off for appointments (and more), according to Investigative Ophthalmology and Visual Science.

“I always pre-appoint my patients for their next visit, which is preceded by a reminder phone call,” explains Paul Chous, M.A., O.D., “I emphasize the often asymptomatic nature of eye disease, I try to find some abnormality or sub-optimal finding that should be monitored at future appointments — not just diabetic retinopathy, but more subtle diabetes findings, such as inner retinal thinning — and I show images of diabetic eye disease in comparison to my patients’ images to emphasize that early detection allows for early intervention with a goal of minimizing progression.”

Dr. Chous adds that he uses patient handouts to explain the importance of annual dilated fundus exams and a letter to the patient’s primary care doctor, with a patient copy, with the recommended surveillance interval.

Blair Lonsberry, MS, O.D., ME.d., F.A.A.O., says he’s been able to increase patient compliance to appointments by equating the patient’s ocular findings with systemic issues.

“One of the statements that I use that seems to have impact with patients is if they have diabetic changes in their eyes, like hemorrhages or exudative leakage, then the same thing is happening in their heart and their kidneys,” he says. “So, it is important that we monitor the changes going on in their eyes, as it is a good indicator of what is going on with their body.”

Charles W. Ficco, O.D., says he usually quotes a statistic about diabetes being the leading cause of legal blindness and then tells his patients that they do not have to be a part of that statistic.

“I say, ‘If you take your medications as directed, monitor your blood sugar regularly and have your eyes checked annually, we can prevent you from losing your sight.’ I also give examples of some of my Type 1 diabetic patients who have had diabetes for 30 or more years, but still do not have any signs of diabetic retinopathy. And the reason for this is they are very proactive and strict about their blood sugar control, plain and simple.” ■