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Mobile TeleOphthalmology clinics bring diagnosis and care to First Nations communities in B.C.

There are many health problems associated with diabetes.

Among the most serious are heart disease, renal failure, amputation of the lower limbs and retinal damage, or retinopathy. People with retinopathy are 29 times more likely than the general population to go blind. As a result, diabetes is a leading cause of blindness.

On Vancouver Island, the British Columbia TeleOphthalmology innovation is helping physicians diagnose, track and treat vision problems associated with diabetes in remote First Nations communities. BC's Inter Tribal Health Authority which is leading the project with clinical support from the Vancouver Island Ophthalmologists and financial support from Canada Health Infoway and First Nations Inuit Health, Health Canada launched the initiative in April.

Mobile retinal screening clinics have been set up to serve the 51 First Nations communities on the island. These mobile clinics, consisting of two First Nations technicians and a registered nurse, travel to the communities to conduct retinal scans of all residents who suffer from diabetes. The scans are downloaded to a server and then sent to Vancouver Island retinal specialists for assessment. Dr. Glen Hoar is one of those specialists.

"This program has provided a significant improvement in our ability to provide retinal screening to patients in remote communities who might otherwise not have the ability to access care. Our preliminary results have been very encouraging," says Dr. Hoar.

It is estimated that the prevalence of diabetes is 40 per cent higher among First Nations people in BC than among other British Columbians. The remoteness of many First Nations communities makes treating the disease very difficult, which means that people have been suffering vision loss that would have been preventable with early treatment. Shelley Ellis is the Inter Tribal Health Authority nurse on the TeleOphthalmology Project working to reverse that trend.

"We had a woman who just two days previously had had a lower leg amputated because nobody had noticed the spreading infection. That happens too often with diabetes," says Ellis. "Thankfully, though, she came to our clinic to get her eyes examined. Our specialist in Victoria examined the images, diagnosed retinopathy, and scheduled surgery. That woman was close to losing her vision, but that's not going to happen thanks to this program."

The TeleOphthalmology Project is scheduled to run until March 2011. The Inter Tribal Health Authority is working hard to secure longer term funding to ensure the program is sustainable.

Ellis says, "We've seen the results from our first five months. I know what this health care service can do, how much we can help. This is about health care and health promotion. It's about helping people own their health. We're doing things with this project and this technology that we could never have done 15 years ago. I believe it's the future of health care."

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