In Reply Our teleretinal diabetic retinopathy screening (TDRS) program1 was implemented to address the large backlog of persons with diabetes in Los Angeles County waiting for diabetic retinopathy (DR) screening examinations. As stated in our article, our TDRS program is intended solely for DR screening; it is not intended to replace a comprehensive eye examination to rule out the presence of conditions such as glaucoma. However, it is clear that the highest risk of blindness posed to our patient population is from diabetic retinopathy. Although the pre-TDRS mean wait time for screening of 158 days may be acceptable for lower levels of diabetic retinopathy, it is not an acceptable wait time for a screening examination to determine who falls into that category. As evidenced by our historically low screening rate and long wait times for DR screening examinations, many of these patients were not getting adequate eye care, or any eye care at all, prior to the implementation of our TDRS program. This is a major challenge for the US safety net.2
Daskivich LP, Mangione CM. Current Shortcomings of Camera Screening—Reply. JAMA Intern Med. 2017;177(10):1539–1540. doi:10.1001/jamainternmed.2017.3836
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