4 Nov 2013

NZ eye surgeon details extent of diabetes on Niue

5:44 pm on 4 November 2013

A New Zealand eye surgeon says the majority of patients checked in a recent clinics she conducted on Niue had diabetes.

Dr Sarah Welch, who has made regular visits to Niue to provide treatments, says eye problems caused by diabetes need to be treated early or the patient risks blindness.

Dr Welch told Don Wiseman that Niue can only provide rudimentary medical care.

SARAH WELCH: They have two doctors permanently on Niue, so there's one person who can deliver babies and provide anaesthetic and there's another person who does the regular GP and some minor surgical work and stuff. But most of the more specialist treatment, such as eye care or orthopaedic care, patients either fly to New Zealand, and some find that very difficult, or else doctors go up there.

DON WISEMAN: As far as Niue goes, how bad is the situation with regard to eyes?

SW: I think Niue is luckier than some islands in that perhaps the prevalence of diabetes is not quite as widespread in some islands. But diabetes is slowly increasing within the community and there's over 200 diabetics there in Niue who need annual eye checks. And we saw a number of people who had such severe eye disease from their diabetes that without treatment they could go blind.

DW: So the sort of treatment you were giving people was surgery? What were you doing?

SW: Well, if people have very severe disease, the main treatment for severe diabetic disease is surgery. Unfortunately, that's not the sort of surgery that can be done in Niue, so that's something that people have had to be referred back to New Zealand for. If we can catch people in time, a better treatment is to be able to give people laser.

DW: Now, you want to set up a screening programme to ensure there's a methodical process to see all of these people with diabetes on a regular basis.

SW: That's right. As I said, we saw a bit over 100 people on our last trip, and we presumed that we'd seen all the diabetics. Because generally diabetics everywhere should have their eyes screened every year as a baseline screening. And the great thing about screening is we can find somebody who's go the beginnings of problems and we can treat it with laser. Often the disease doesn't progress. But if it's left and nobody knows about it and they present when their vision is going bad, then that's the point where they need surgery and there's less chance of getting the vision back to 100% and much more risks and obviously it's much more expensive and more risk to the patient.

DW: So the screening programme will involve what?

SW: Somebody will go annually and will be able to take photos - somewhat similar to the screening programme that we have in Auckland. Most diabetics in New Zealand should be on a screening programme for their eyes. And in a lot of places that's done with photography. So people go along to their local optometrist or their local diabetic centre and get photos of their eyes. If everything is fine they're told that they can come back in a year. If there's a problem then they're referred on to the doctor and then we can do treatment as needed.