Factors associated with annual eye examination among adults with diabetes in the United States: 2005-2010

Objective:  Early detection of retinopathy by annual eye examination is important to reduce the risk of vision loss and is cost-effective to mitigate burdens of diabetes.  This study aims to exam the rate and predictors of annual eye examination among adults with diabetes in the United States (U.S.).

Method: This study used the National Health and Nutrition Examination Survey (NHNES 2005-2010). Self-reported dilated eye exam within one year was defined as having annual eye examination. Predictors such as socio-demographics, insurance status, and diabetes education were included in the multiple survey logistic regression, accounted the complex survey design. Estimates were weighted to the total population (WTP).

Results: Among 2045 (WTP: 18,147,900) patients aged >=20 years with diabetes, 61.66% (WTP: 11,190,318) had annual eye examination over 6 years (2005-2010), slightly decreased from 62.4% in year 2005-2006 to 61.3% in year 2009-2010. The insurance coverage (adjusted odds ratio (aOR): 2.79, 95% confidence interval (95% CI):1.90-4.09), higher education (aOR: 1.57, 95% CI: 1.10-2.24), non-Hispanic white (aOR: 0.74, 95% CI: 0.56-0.97) and having regular diabetes care physician (aOR: 1.79, 95% CI: 1.35-2.38) were significant predictors for annual eye examination. Patient who saw diabetes educator within two years (aOR: 1.43, 95% CI: 1.12-1.81) were more likely to have annual eye exam as compared with those that did not.

Conclusion:  Nearly 40% U.S. patients with diabetes do not receive annual eye examination according to the ADA guidelines.  Modifiable variables such as insurance coverage, better education, having regular diabetes care physician, and diabetes education promote annual eye examination.