From Little Things: KeepSight Grows to Protect Eye Health

Since launching a little over a year ago in March 2019, KeepSight has gained tremendous momentum and is beginning to have a significant impact on the eye health of Australians living with diabetes.

Had it not been for the disruption of COVID-19, ophthalmologist Associate Professor Peter van Wijngaarden, who helped to initiate the program, says that KeepSight would have been on track to have enrolled 250,000 people by the end of 2020. This early success showcases the strong linkages that have been established between Diabetes Australia, Optometry Australia and optometrists, ophthalmologists, GPs and service providers such as Oculo. All parties are working together to encourage and make it easy for people with diabetes to participate.

We have all the ingredients for success and the key is to have advocates of KeepSight in every optometrist and ophthalmologist across the country

“Because of COVID-19, routine optometry for elective eye checks has been at a stand-still, and this has slowed growth in KeepSight enrollments, however we have recently started sending out reminders to those people who enrolled early and who are now due to reattend for diabetes eye checks,” said A/Prof van Wijngaarden.

“As the sector returns to seeing people for routine care, diabetes eye check reminders are more important than ever so we can ensure no one falls through the cracks”.

AN INDEPENDENT VOICE

The KeepSight reminders are being sent by Diabetes Australia, which A/Prof van Wijngaarden says is critical to the program’s success.

“Our research has indicated that independence is very important to people with diabetes – they appreciate that Diabetes Australia has no vested commercial interest in people attending eye appointments.”

Additionally, he said Diabetes Australia’s administration of the National Diabetes Services Scheme, for more than 30 years, means the organisation is widely seen as ‘a trusted voice’.

Research has also confirmed that the reminders are much appreciated by the vast majority of people with diabetes who understandably find it hard to keep on top of appointments that are set months or years in advance, especially when juggling many other competing health priorities that come with diabetes.

Compounding these challenges are other perceived barriers to regular eye checks. Diabetes Australia’s research has found that people living with diabetes often believe:

• If they’re not experiencing symptoms, there’s no need to have their eyes screened,
• If everything was OK at the last check up, then it’s OK to miss the next scheduled check in a year or two’s time, and
• A diabetes eye check may leave them out of pocket or they may be sold other services or products at the time of attendance.

A/Prof van Wijngaarden says the KeepSight program provides the perfect vehicle to tackle these misconceptions.

“As a trusted, independent voice, Diabetes Australia can deliver good clear information to ensure people understand the importance of regular diabetes eye checks and know that bulk billed eye checks are available in most instances.”

However, with diabetes crossing socioeconomic and cultural boundaries, and impacting over 1.3 million Australians, there is no single message that resonates with everyone.

Taryn Black, National Policy and Program Director at Diabetes Australia said one of the challenges is that because diabetes eye disease can be asymptomatic, people often put routine eye checks ‘down the list’.

The reality is that a regular diabetes eye check is the best way to identify early problems, and then ensure early treatment.

“People with diabetes have many regular health checks they need and often diabetes eye checks are put off, or forgotten about, because there are more pressing health issues to address,” said Ms Black.

“This is where KeepSight comes in. By providing people with a reminder from a trusted source when their eye check is due, we aim to take some of the burden away.

“For some people, it’s about remembering, for others it’s about prioritising, and for some it’s about informing the importance of regular checks. No one should lose their sight when, in the vast majority of cases, diabetes-related vision loss can be prevented through regular eye checks and early, effective intervention.”

IMPORTANT ROLE FOR OPTOMETRY

With KeepSight now up and running, A/Prof van Wijngaarden says optometrists have a very important role to play in ensuring people with diabetes have regular eye screenings and take care of their eye health.

“Our audits show that return visits for screenings are far below what is desirable. Many of those who are found to have mild or no diabetic retinopathy will not return for follow-up screening at the recommended time. So the notion that one regular recall cycle is enough does not stack up – we need optometrists to continue to recall their patients on a timely basis and KeepSight reminders serve as a safeguard.”

reminders from Diabetes Australia should not stop an optometrist from sending out their own patient recalls – the more points of contact, the greater our chance of ensuring a person attends a follow-up screening

Ms Black, agrees. “Our consumer research last year showed that people with diabetes want more reminders. So reminders from Diabetes Australia should not stop an optometrist from sending out their own patient recalls – the more points of contact, the greater our chance of ensuring a person attends a follow-up screening. Evidence has suggested over 600,000 Australians with diabetes are not having the regular eye checks they need.”

A/Prof van Wijngaarden said, “For the program to work effectively, we need consumer and clinician engagement – it’s important that we know when people have returned for their eye checks and when they’re due to come back for their next check – then we can get a contemporaneous view of diabetic eye screening across the nation. This will be tremendously powerful. Once we fully understand which groups of people are missing out on screening, we can focus our efforts on particular areas or community groups that are missing out.”

EVERYONE’S PROGRAM

In the early days of KeepSight, some eye care providers were concerned that patients who registered with the program could be contacted and offered screening by competitors. Now that KeepSight is well established, and with Diabetes Australia managing all communication with registrants, A/Prof van Wijngaarden hopes this is no longer the case. Along with building trust with people with diabetes and eye care providers, the KeepSight team has prioritised ease of registration and interaction with the program.

“KeepSight has formed a strong partnership with Optometry Australia and we are working hard to streamline linkages between KeepSight and the majority of service providers. The goal is to make it as easy as possible to directly register patients with KeepSight, irrespective of where you practice,” said A/Prof van Wijngaarden.

“I really would like every Australian eye care provider to view KeepSight as a program that they have ownership of and a sense of pride in. As simple as it may seem, KeepSight is highly innovative and it is set to have real impact in preventing needless vision loss from diabetic eye disease. We have all the ingredients for success and the key is to have advocates of KeepSight in every optometrist and ophthalmologist across the country.”

To register patients for KeepSight or to find out more, visit keepsight.org.au.