Diabetic retinopathy (DR) is a public health concern in Nigeria as in other low and middle-income countries (LMICs). According to the Nigerian Blindness and Visual Impairment survey, 20.5% of people with diabetes had DR and 10% were at risk of sight loss. The pooled prevalence of DR from a recent systematic meta-analysis is 21.3%.
These figures are likely to increase due to demographic shifts and the rising prevalence of diabetes from lifestyle changes and the health system must be ready to respond to this challenge.
This guideline is a paradigm shift from a fragmented methodology towards a nationally effective framework with a cohesive, cost-effective, comprehensive, and patient-centred approach, critical to making the needed impact by increasing the opportunity for prevention and prompt treatment at early stages.
Service integration is one of the enablers underpinning the main strategic thrusts of the National Eye Health policy. This document aligns with the National Eye Health Policy and the National DM guidelines, integrating DR services into the routine diabetic service structures at the primary, secondary, and tertiary levels.
These guidelines recommend strategies to strengthen leadership and clinical governance, protocols that standardize care and define care pathways including strengthening referral mechanisms, financing and sustainability and research to improve service delivery and patient outcomes in the long run.