Objective To examine the use of ophthalmologic care by African Americans with type 1 diabetes. Design Cross-sectional study between 1993 and 1997. Participants Seven hundred twenty-two African Americans with type 1 diabetes. Methods A structured clinical interview was conducted to determine (1) the frequency of annual dilated eye examinations, health insurance, use of an ophthalmologist, and reasons for lack of eye care; and (2) factors associated with having a dilated eye examination by an ophthalmologist during the previous year. All patients also underwent a detailed ocular examination, including masked grading of 7-field stereoscopic fundus photographs. Results One third of the patients had never been examined by an ophthalmologist. Of those who had eye care, almost half did not have a regular ophthalmologist. During the previous 12 months, only 42% of patients had had a dilated eye examination by an ophthalmologist, despite the fact that approximately three fourths of the patients had been told to do so. The 2 most common reasons given for not seeing an ophthalmologist during the previous year were not having any eye problem (57.6%) and cost (23%). Patients more likely to have had a dilated eye examination by an ophthalmologist during the previous year were married, had higher socioeconomic status, had previously been told about annual dilated eye examinations, and had previously been diagnosed with either a cataract or proliferative diabetic retinopathy. Conclusions A large percentage of African Americans with type 1 diabetes do not receive adequate eye care. Screening for diabetic retinopathy and improved access to ophthalmologists are needed to improve eye care in this ethnic group.
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