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The program is designed to detect sight threatening diabetic retinopathy with a high sensitivity. Other conditions such as glaucoma and cataracts may be detected as well. However, the sensitivity of detecting these other conditions is not sufficient for diabetic retinopathy screening to take the place of a regular eye exam.

It is recommended that all patients with diabetes receive screening in order to have baseline information, to provide images for patient education, to improve detection of retinopathy lesions, and to show other microvascular signs of chronic disease such as hypertension.

However, retinopathy screening may not be indicated for patients who have had a retinal exam within a year, when the primary care clinician has received a report from the examining eye care provider regarding the retinal status of their diabetic patients.

No. The purpose of the program is timely identification of patients with sight-threatening diabetic complications. We highly recommend patients to continue seeking regular eye care.

The retinal camera rests on a table, with the photographer and patient positioned on either side of the device. A computer may be placed nearby to view full size images from the camera. The camera requires a darkened room or a shroud over the patient in order to capture quality images. Excessive light causes pupillary constriction, which affects image quality.

We can take satisfactory images with undilated pupils for approximately 90% of patients. With the other 10 percent who have small pupils, cataracts, or other abnormalities, we may need to dilate their pupils to acquire adequate images. Alternatively, these patients may be referred to an eye care provider for a live exam.

There are four ways that notification can occur through the EyePACS platform:

1. Primary care clinics can download reports from EyePACS where recommendations for treatment or follow-up are indicated for each patient.
2. EyePACS reports can be automatically integrated into a clinic’s electronic medical record or electronic registry.
3. EyePACS directly notifies providers via email indicating the need for an urgent referral.
4. EyePACS calls providers when referrals are urgent.

Medi-Cal, Medicare, and several other third party payers provide coverage for retinal exams. Encounters in primary care are billable under CPT codes 92250, 92227 and 92228 (primary care clinics should bill global services, not just the technical component) and are a validated procedure for quality measures, such as HEDIS.