Diabetic retinopathy in a hospital eye clinic population in Honiara,Solomon Islands

Background: To determine the presence, severity and context of diabetic retinopathy among diabetic adults using hospital eye clinic services in Honiara, Solomon Islands. Methods: Fifty consecutive known diabetic patients aged ≥20 years were interviewed and underwent Snellen distance vision testing and complete ocular examination, including dilated 90 D funduscopy. Diabetic retinopathy was graded according to the International Clinical Diabetic Retinopathy and Macular Oedema Disease Severity Scales. Results: Participants were predominantly Melanesian (94%). Mean age was 53.6 ± 10.7 years; 42% were female; and 34% were rural dwellers. Diabetes had been diagnosed <5, 5–10 and >10 years ago for 42%, 34% and 24% of participants. However, 54% denied ever having had a dilated fundus examination. Proliferative retinopathy, severe non‐proliferative changes and maculopathy were present in 5, 12 and 26 eyes, respectively. For the 32 eyes with pinhole acuity ≤6/12, diabetic eye disease was the cause for 20, with all but one due to maculopathy. Diabetes reduced the pinhole vision of five eyes to ≤6/60. Twenty‐four per cent of participants had diabetes‐related pinhole vision ≤6/12 in at least one eye. Those diagnosed with diabetes 5–10 and >10 years were 17.5 and 58.8 times more likely to have such an eye compared with those recently (<5 years) diagnosed (extended Mantel–Haenszel χ² = 11.570, P < 0.001). Participants were not well informed about diabetic eye disease. Conclusions: Diabetic eye disease is now a significant contributor to this clinic's workload. A population‐based survey is needed to quantify the problem and inform design and delivery of eye services for this chronic disease.