preprint · medRxiv
Rising rates of diabetes have increased the risk of blindness from diabetic retinopathy, particularly in resource-limited settings such as Tanzania where prompt access to specialised eye care is critical. This study investigated the factors that affect whether patients with diabetes attend diabetic eye services at a tertiary hospital in Dar es Salaam. Through qualitative interviews with fourteen patients attending an eye clinic, the research identified specific obstacles and enablers. Major barriers included the direct financial costs of services, a lack of awareness regarding diabetes-related vision damage, fear, and competing life priorities. Conversely, key enablers that encouraged attendance included direct referrals from primary healthcare workers, the onset of noticeable eye symptoms, existing awareness of diabetic eye risks, geographic proximity to the clinic, family encouragement, and health insurance coverage.
Diabetic retinopathy can cause irreversible blindness if it is not caught and managed early. Understanding what stops or encourages patients in resource-constrained environments to seek eye examinations allows healthcare systems to design targeted educational campaigns, reduce structural obstacles such as costs, and establish stronger referral networks from primary clinics to specialist centres.
The abstract does not indicate a direct commercial application pathway, as it is an early-stage qualitative healthcare study focused on patient-reported barriers and facilitators. However, the findings provide operational insight for public health programmes, healthcare providers, and insurance organisations aiming to design better patient referral systems and awareness programmes to improve eye care uptake.
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Abstract Background The increase in prevalence of Diabetes has led to a rise in the burden of blindness due to diabetic retinopathy. Timely access to diabetic eye care may prevent blindness due to diabetic complications, reducing the burden of blindness in countries with limited resources like Tanzania. This study aimed to explore the factors influencing access to diabetic eye care among people living with diabetes attending a tertiary hospital. Methods A total of 14 interviews were conducted with people living with diabetes attending a tertiary hospital from March 2023 to May 2023. Participants were purposively selected during their visits to the eye clinic. The interviews were audio-recorded, transcribed verbatim, and analysed by qualitative content analysis. Results Factors influencing access to diabetic eye care among people living with diabetes were reported, including the cost of eye care services, not knowing that diabetes can affect eyes, fear, and having other priorities emerged as barriers to accessing care while referral from primary healthcare workers, eye symptoms, knowing that diabetes can affect eyes, living close to the facility offering eye care services, influence from close relatives, and having health insurance were reported as facilitators to attending diabetic eye care services. Conclusion Educating individuals with diabetes about the importance of diabetic eye care, while addressing the barriers to accessing it, will help them receive timely diabetic eye care and prevent blindness caused by diabetic retinopathy.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1101/2025.10.04.25337039
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