Lima GV, Gracida HGA

Language: Spanish
References: 13
Page: 146-150
PDF size: 56.15 Kb.

ABSTRACT

Background. Undergraduate physicians take care of diabetic and hypertensive patients during social service; the rate of these patients that have ocular fundus alterations and require referral is unknown. A study was performed to identify this rate, to estimate the need of the competence in ocular fundus evaluation during social service and to evaluate the safety of using mydriatics at primary care. Methods. Hypertensive and diabetic patients from a social service settlement were evaluated with indirect ophthalmoscopy and mydriasis. The rates of diabetic retinopathy, hypertensive retinopathy and other ocular fundus alterations, as well as blood pressure changes with the mydriatic and the rate of anterior chamber angle closure. The rate of diabetic retinopathy was compared with that of urban population. Results. 46 patients were evaluated (age 30-73 years): 37 were diabetic (80.4%) and 22 hypertensive (47.8%). Five diabetics had retinopathy (13.5%); features suggestive of glaucoma were found in 10 patients. Diastolic blood pressure changed with mydriasis (p = 0.01), but it did not exceed 90 mm Hg. Neither hypertensive retinopathy nor angle closure were found; the rate of diabetic retinopathy (10.9%) did not differ from that reported (p › 0.05). Discussion. 15 patients has ocular fundus alterations that required referral (32.6%, 95% CI 19.05-46.1); the competence of ocular fundus evaluation was considered necessary during social service, in order to be able to detect those alterations; evaluation with mydriasis was safe, but it requires from the explorer the ability to evaluate anterior chamber width, and that the patient has low diastolic blood pressure.

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