A national eye-screening programme, potentially delivered as part of a universal healthcare scheme, could catch chronic conditions in people unaware of serious complications in their future, a visiting diabetes specialist has warned.

A public lecture this evening by David Owens, emeritus professor of diabetes at Cardiff University in Wales, will reveal early results from screening conducted 18 months ago in Bermuda.

Dr Owens said the eye screening carried out last year on some of the island’s diabetes patients revealed a high rate of damage to the retina that can lead to visual impairment or blindness.

The procedure can reliably spot the lurking risk of stroke, heart disease and other conditions simply by examining nerves and blood vessels within the patient’s eyes.

“What I say is, there’s a window of opportunity — don’t pull the blinds down and miss the opportunity,” Dr Owens told The Royal Gazette.

He suggested that Bermuda might emulate the diabetic eye-screening programme run under Britain’s National Health Service.

The scheme makes a regular practice of studying patients with diabetes aged 12 and over, scanning for the signs of retinopathy caused by high blood sugar damaging vision.

Bermuda adopting a similar programme under universal healthcare would be “a vehicle for insuring consistency” in arresting a condition that can lead to blindness, Dr Owens said.

He added: “It’s a great opportunity, because using artificial intelligence we can look at the eye without any other information, and predict the risk of cardiovascular disease — purely from looking at the back of the eye.”

Dr Owens has returned to the island as a guest of the Bermuda Diabetes Association, which is marking its 45th anniversary today with an annual general meeting and the public talk at Axa XL on Bermudiana Road in Hamilton from 5.30pm to 7pm.

Type 2 diabetes, mainly driven by diet, exercise and other lifestyle choices, affects 95 per cent of Bermuda’s diabetes patients.

It is one of the island’s top chronic non-communicable diseases, with complications including damage to the kidneys as well as the eyes, heart disease, stroke, increased risk of dementia and amputations caused by blood vessel damage.

Dr Owens said: “The problem with type 2 diabetes is you think you would know if you had it. In many cases, you don’t.

“There are people with undiagnosed type 2 diabetes and they’re the same number as there are known.

“There’s a condition called pre-diabetes as well, and these guys are sitting in the wings waiting to fall into this pool.”

He highlighted that approximately 13 per cent of the island’s population has diabetes, climbing to 23 per cent in people over age 50.

“Basically, each of those are potentially at risk,” Dr Owens said, noting the island compares poorly alongside other countries in the Organisation for Economic Co-operation and Development.

“I looked at the literature for Bermuda, and compared with the OECD, the amputation rate of the lower extremities is four times on average of that seen in other countries.”

Dr Owens said many diabetes patients at risk for losing their sight were unaware of “a most frightful complication of diabetes” that could be caught relatively easily by a physician trained in the use of an ophthalmoscope for eye examinations.

“The screening is the No 1 way to prevent those people with retinopathy from going blind,” he said.

“It’s not a diagnostic test in itself, but if there’s a suspicion of a possibility that things are not where they should be, then on that basis you can decide on a care pathway.”

Screening across Britain has resulted in retinopathy falling from its place as the No 1 cause of blindness in Britain — an example he suggested that the island could follow.

Last year, Dr Owens and his team studied 172 diabetes patients in Bermuda who were thought to be at high risk, and ended up referring 41 to ophthalmologists because they either had retinopathy or other serious eye conditions such as glaucoma and cataracts.

He added: “Of that number, almost half required some intervention, be it laser therapy or cataract surgery. Some of them are still waiting to be seen.

“The key message is that they had a problem and were unaware of it, to the extent that a significant number required therapy to preserve their vision.

“So my question to Bermuda is, what’s next? You’re getting this evidence now. Are you intending to introduce a national screening programme — and if you are, how?”

He said the estimate of the cost of Britain’s programme was roughly £30 a session, or a little under $40.

The study’s findings, to be shared at the lecture tonight, come with “the suspicion that the problem is more common in the uninsured and underinsured”.

As well as improving patients’ quality of life, the screening is “cost-effective”, Dr Owens said, because visual impairment puts patients at risk of other medical complications.

He added that the blood vessels and nerve fibres analysed in an eye examination could tell a physician of the patient’s risk “within five or ten years of being likely to have a stroke”.

Damage to nerve fibres in the eyes could also suggest nerve damage in peripheral areas such as the feet, which contribute to the island’s comparatively high rate of amputations.

“The eyes can be used as a window of opportunity,” Dr Owens said. “That’s what we convey to the patient.”

Dr Owens was responsible for introducing the first community-wide National Diabetic Retinopathy Screening Service for Wales in 2002, and has gone on to introduce screening in other countries.

He is also conducting studies on diabetic foot care, and has led the establishment of diabetes care services in Mauritius, Trinidad and Peru.

Aside from discussing the results of his screening, Dr Owens will include the importance of managing diabetes in this evening’s talk.

“The message is that this is the way you should look after your diabetes, by maintaining good control of your blood sugar,” he said.

“If you’re in the early stages of diabetes, where you’re overweight and starting to have problems, you can theoretically reverse the disease.”