Victorian orthoptists' performance in the photo evaluation of diabetic retinopathy

PURPOSE: The aim of this study was to investigate the effectiveness of orthoptists in detecting various grades of diabetic retinopathy (DR) and retinal pathology not directly associated with diabetes and to identify factors associated with best performance. METHODS: Forty-five orthoptists completed a survey comprising questions regarding their workplace experiences, plus a photo evaluation task with 36 digital fundus images. RESULTS: We found that orthoptists' overall performance in detecting the presence of abnormality in a series of DR images was high, the mean sensitivity being 86% and specificity 91%. The sensitivity was lower for images with minimal non-proliferative DR, but higher for those with mild-moderate and severe grades of DR. No factors were predictive of performance on the screening task. CONCLUSIONS: Orthoptists performed extremely well, meeting the guidelines for DR screening recommended by National Health and Medical Research Council. The results indicate that orthoptists could potentially be used in DR screening models in Australia.