Diabetic retinopathy in rural communities: a review of barriers to access of care and potential solutions

Abstract

Introduction. Diabetic retinopathy (DR) is a leading cause of vision loss. With an estimated 38.4 million Americans diagnosed with DM, the disease exerts a significant burden on healthcare systems, especially in rural areas where access to care is limited. DR prevalence is notably higher in rural communities due to barriers such as geographical isolation, lower socioeconomic status, and provider shortages. Objective. This narrative review explores the current state of DR management in rural areas, highlighting the increased incidence of the condition in these regions and the unique challenges faced by rural patients. Barriers to Care. Key barriers to care include distance and travel, financial constraints, and a lack of ophthalmology and optometry specialists. Solutions. The review also discusses potential solutions to improve DR outcomes, including teleophthalmology, artificial intelligence (AI) screening, and expanding rural healthcare workforce programs. These interventions aim to improve early detection and access to treatment, ultimately reducing the disparity in DR care between rural and urban populations. Comprehensive efforts from policymakers, healthcare systems, and educational institutions will be crucial in addressing the gaps in rural DR care and improving patient outcomes.