Comm Eye Health Vol. 20 No. 61 2007 pp 16. Published online 01 March 2007.

Awareness about eye diseases among diabetic patients: a survey in South India

SJ Saikumar, A Giridhar, G Mahesh, A Elias, and S Bhat

Giridhar Eye Institute, Kochi 682 020, Kerala, India. Email: Website:

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Diabetes mellitus (DM) is reaching epidemic proportions in many countries, including India. Currently, there are 171 million diabetic patients worldwide. By 2030, this figure is projected to increase to 366 million people, 79 million of whom will be in India. This is likely to have major implications for India, which is estimated to be home to a quarter of the world’s blind population. Awareness about the eye complications of diabetes can play an important role in encouraging people to seek timely eye care.

We conducted a survey using a 20-point questionnaire among 1,000 diabetic patients who attended our out-patient department between October 2001 and March 2002. We assessed awareness about the eye complications of diabetes and asked patients how awareness could be increased.

Eighty-six per cent of patients were aware that DM could affect many parts of the body; 84 per cent knew that DM could affect the eye. Among those who were aware that DM could affect the eye, 36 per cent learnt this through the media, 32 per cent from other eye specialists and 30 per cent from their general practitioners or physicians. Among those who were aware that DM could affect the eye, 51 per cent did not know exactly which part of the eye could be affected, 28.3 per cent thought that cataract was the main eye complication, and 19 per cent thought that DM mainly affected the ‘nerves in the eye’ (presumably retinopathy). Around 50 per cent of the patients knew that routine eye checks were necessary even if DM was well controlled, while the remainder thought that routine eye examinations were not necessary in that case. To increase knowledge, better media coverage was suggested by 36.8 per cent. The rest suggested better communication from physicians (32.7 per cent), eye specialists (19.8 per cent), and health and paramedical workers (10.7 per cent).

Awareness is not the same as knowledge. Hearing about a problem is awareness, but understanding the causes or treatment of a disease, for example, is knowledge. Eighty-four per cent of the patients were aware that DM could affect the eye, so awareness is quite high. But knowledge levels were lower: only 46.9 per cent of those interviewed knew that retinopathy was related to the control of DM, and only 40.3 per cent knew that it was related to the duration of DM. Among those who were aware that DM could affect the eye, 51 per cent did not know what the eye complications could be. As this study was done in an eye hospital, knowledge levels amongst diabetic patients in the general population are likely to be lower.

The control of visual impairment from diabetes requires good disease control and regular eye examinations. Screening diabetic patients for retinopathy poses considerable challenges, particularly in a country like India where the numbers are large and many diabetic patients are unlikely to be aware that they need regular eye examinations. This study shows that, as a first step, there is a need to increase awareness and knowledge of the potentially sight-threatening complications of diabetes.