Measure titleEye ExamMeasure IDEED_DRP
Description

The percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam during the measurement period.

Measurement period.
Copyright and disclaimer notice

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Clinical recommendation statement

American Diabetes Association (2022)

  • Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist within 5 years after the onset of diabetes. Level of evidence: B
  • Patients with type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of the diabetes diagnosis. Level of evidence: B
  • If there is no evidence of retinopathy for one or more annual eye exams and glycemia is well controlled, then screening every 1–2 years may be considered. If any level of diabetic retinopathy is present, subsequent dilated retinal examinations should be repeated at least annually by an ophthalmologist or optometrist. If retinopathy is progressing or sight-threatening, then examinations will be required more frequently. Level of evidence: B

American Optometric Association (2019)

  • Type 1 Diabetes: A baseline comprehensive eye and vision examination should be performed on children and adults with T1D, with follow-up examination as directed by their eye doctor. Level of Evidence: B, strong
  • Type 2 Diabetes: As diabetes may go undetected for many years, any individual with T2D should have a comprehensive eye and vision examination soon after the diagnosis of the condition, with follow-up examination as directed by their eye doctor. Level of Evidence: B, strong

Joslin Diabetes Center (2020)

  • Refer patient for comprehensive dilated eye exam or validated retinal imaging to determine level of retinopathy.
  • Type 1 Diabetes: Initial eye exam at start of puberty or once patient is 10 years of age or older, whichever is earlier, within 3 to 5 years of diagnosis. Annual eye exam thereafter. Grade of Recommendation: 1A
  • Type 2 Diabetes: At diagnosis and annually thereafter. Grade of Recommendation: 1A
Citations

American Diabetes Association Professional Practice Committee. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Medical Care in Diabetes—2022. Diabetes Care 2022;45(1), 185–194, https://doi.org/10.2337/dc22-S012

AOA Evidence-Based Optometry Guideline Development Group. 2019. Eye Care of the Patient with Diabetes Mellitus. American Optometric Association. https://www.aoa.org/AOA/Documents/Practice%20Management/Clinical%20Guidelines/EBO%20Guidelines/Eye%20Care%20of%20the%20Patient%20with%20Diabetes%20Mellitus%2C%20Second%20Edition.pdf

Joslin Diabetes Center Clinical Oversight Committee. Clinical Guidelines for Management of Adults with Diabetes. 2020. https://joslin-prod.s3.amazonaws.com/www.joslin.org/assets/2020-08/clinicalguidelinesformanagementofadultswithdiabetes.pdf

Characteristics
ScoringProportion.
TypeProcess.
Stratification
None.
Risk adjustmentNone.
Improvement notationA higher rate indicates better performance.
Guidance

[TBD]

Definitions
Initial population

Patients 18-75 years of age by the end of the measurement period who had a visit during the measurement period, and a diagnosis of diabetes that is ongoing or starts during the first six months of the measurement period.

Exclusions

  • Patients in hospice or using hospice services any time during the measurement period.
  • Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
  • Patients 66 and older by the end of the measurement period, with frailty and advanced illness.
  • Patients receiving palliative care during the measurement period.
  • Patients who have had either a bilateral eye enucleation, or both a left and right eye enucleation before or during the measurement period.

Denominator

The initial population, minus exclusions.

Numerator

Patients with an eye exam for diabetic retinal disease. This includes patients with diabetes who had one of the following:

  • A diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period.
  • No diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period.

Data criteria (element level)

Table of Contents

  1. Definitions
  2. Functions

Definitions

Functions