Is seeing really believing? Patient responses to retinal images in routine retinopathy screening sessions

Abstract

Background Annual diabetic retinopathy screening provides an opportunity to relay visual feedback about patients' eye health. Viewing retinal images in the screening session has become standard care, but patients’ understanding of their retinopathy risk and the link between diabetes and eye health is unclear. This study explored patients' experiences of viewing images and the impact this may have on illness cognitions and diabetes management. Methods Twelve semi-structured interviews were conducted with patients attending hospital-based diabetic eye screening in London. Five had retinal changes detected in the screening session. Verbatim transcripts were analysed using thematic analysis. Findings Two themes emerged: mood alteration and images as facilitators of communication with a health professional. The images were perceived as a valued part of the screening. They facilitated communication with the health professional, but repeated exposure to retinal images could result in habituation. Patients tended to use defensive coping, downplaying the significance of retinopathy, perceiving existing changes as reversible. Viewing images didn't alter motivation to control diabetes. Conclusion Access to diabetic retinopathy images is valued by patients, but it may hinder effective risk communication.