Open Journal of Ophthalmology, 2024, 14, 18-43

[Link]
ISSN Online: 2165-7416
ISSN Print: 2165-7408

Knowledge, Attitude, and Practices Regarding

Diabetic Eye Disease among General Population
in Medina City, Saudi Arabia

Hanan Mustafa Makhdoum1, Fai Anas Mahrous2*, Esraa Khalaf Alshareef2,

Reenad Saeid Ghunaim3, Areej Osama Abukhodair4, Mona Abdulaziz Alburkani5
1
Ophthalmology Department, College of Medicine, Taibah University, Medina, Saudi Arabia
2
Ministry of Health, Medina, Saudi Arabia
3
Internal Medicine Department, National Guard Hospital, Medina, Saudi Arabia
4
Primary Care and Community Health, Medina, Saudi Arabia
5
Ophthalmology Department, Ohud General Hospital, Medina, Saudi Arabia

How to cite this paper: Makhdoum, H.M., Abstract

Mahrous, F.A., Alshareef, E.K., Ghunaim,
R.S., Abukhodair, A.O. and Alburkani, M.A. Background: Diabetic eye disease is known as a group of eye problems that
(2024) Knowledge, Attitude, and Practices diabetic patients may develop as a complication of diabetes and can lead to
Regarding Diabetic Eye Disease among blindness. They may include Diabetic retinopathy (DR), Cataracts, and
General Population in Medina City, Saudi
Arabia. Open Journal of Ophthalmology,
Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and
14, 18-43. practices (KAP) around diabetic eye disease in the general population in-
[Link] cluding patients with DM and non-diabetic people in Medina City, Saudi
Arabia. Methods: This is a cross-sectional study involving 385 participants
Received: December 2, 2023
Accepted: February 16, 2024
via a self-administered online Questionnaire started in January 2023 in Me-
Published: February 19, 2024 dina, Saudi Arabia. Results: In total, 339 participants with ages ranged from
18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed
Copyright © 2024 by author(s) and the questionnaire. The majority were females (74.6%), singles (67.8%), and
Scientific Research Publishing Inc.
had a university level of education (54.6%). Most of the study participants
This work is licensed under the Creative
Commons Attribution International were found to have poor knowledge levels (67%) in comparison to 33% who
License (CC BY 4.0). had an overall good knowledge of diabetic eye diseases. Knowledge level was
[Link] found to be higher among old-aged participants and those with a family his-
Open Access tory of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ atti-
tudes and practices, the study showed good attitudes toward eye care practice
for diabetics with half of the participants (50%) reporting self-awareness as a
reason that made them undergo the first eye screening. Conclusion: Partici-
pants in the present study have poor knowledge and awareness level of di-
abetic eye disease. Furthermore, positive attitudes and perceptions have been
revealed by the participants toward the practice of providing eye care for di-
abetics.

DOI: 10.4236/ojoph.2024.141003 Feb. 19, 2024 18 Open Journal of Ophthalmology

 H. M. Makhdoum et al.

Keywords
Knowledge, Attitude, Practices, Diabetes Mellitus, Eye Disease

1. Introduction
Diabetes mellitus (DM) is a major public health problem defined by the World
Health Organization (WHO) as a disorder that affects the metabolism of the
body and is characterized by chronic high blood glucose levels associated with
defects in carbohydrate, lipid, and protein metabolism, that results from distur-
bances in insulin secretion, insulin action, or both [1].
DM can be classified into three main classes; 1) Type 1 DM which is known as
severe insulin deficiency in the body that makes insulin administration essential.
2) Type 2 DM which is characterized by the body’s tissue resistance to insulin
action combined with insulin secretion deficiency. 3) Type 3 DM is known as
gestational diabetes and is defined as any abnormality in glucose levels that is
detected for the first-time during pregnancy.
Through the past 30 years, DM is still one of the top drivers that is increasing
the global burden. DM was found to be affecting more than 463 million people
worldwide and it is estimated that the number of diabetic patients will double by
2025 [2] [3] [4] [5] [6].
According to International Diabetes Federation, the Middle East, and North
African region has the world’s highest diabetes adult age prevalence of 12.2%. In
2013, Saudi Arabia was the seventh out of the world’s top ten diabetes-prevalence
countries with a high prevalence of 24% specifically, in people aged 20 - 79 years
[1] [3] [4].
DM can lead to different macrovascular and/or microvascular complications
such as cardiovascular diseases, cerebrovascular diseases, diabetic eye disease,
diabetic nephropathy, and diabetic neuropathy. Diabetic eye disease is known as
a group of eye problems that diabetic patients may develop as a complication of
diabetes and can lead to a severe decrease in vision or even blindness. They may
include Diabetic retinopathy (DR), Cataracts, and Glaucoma. In diabetic pa-
tients, high blood glucose level damages the small blood vessels wall in the eye,
changing their structure and function.
These blood vessels may enlarge, leak, form clots, close off, or develop tiny
balloon-like flaws called micro-aneurysms because of this illness, known as di-
abetic retinopathy. Macular edema is the medical term for the fluid buildup that
frequently occurs in the retina used for activities like reading. In severe situa-
tions, a process known as neovascularization causes the retina to lose its blood
supply and sprout new, but damaged blood vessels. These delicate blood vessels
are prone to bleeding, which can lead to scar tissue, hemorrhages that impair vi-
sion, or separation of the retina from the back of the eye (retinal detachment).
Glaucoma can be caused by the new vessels’ ability to obstruct the passage of

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H. M. Makhdoum et al.

fluid inside the eye [2].

Among diabetic eye diseases, DR is considered the most harmful complication
that can result in vision loss for the affected patients. Moreover, other eye dis-
eases affecting vision such as cataracts and glaucoma were found to increase in
prevalence among diabetic patients [7].
Several studies done around the world showed that diabetic eye diseases re-
main the leading cause of visual loss particularly among the adult working age
group [5] [8] [9]. It is estimated that about 15,000 to 39,000 people around the
world lose their vision because of diabetes and about 14.6% aged 40 years and
above, developed diabetic retinopathy after a 5-year duration of diabetes. In
Saudi Arabia, there is a study found that around 36% of diabetic patients expe-
rience stressful retinopathy. Moreover, many studies have proved that micro-
vascular complications such as diabetic eye disease are linked to several risk fac-
tors such as disease duration, poor glycemic control, hypertension, dyslipidemia,
nephropathy, pregnancy, and gender.
The American Diabetes Association and the American Academy of Ophthal-
mology published guidelines stating that type 1 DM patients should begin their
annual eye examinations 5 years after their diagnosis, while patients with type 2
DM should have an annual eye examination starting at the time of the diagnosis.
This helps medical practitioners and physicians to detect diabetic eye diseases in
their earliest and treatable stages [4] [7].
Conclusively, control of the modifiable risk factors through periodic eye ex-
aminations and timely interventions has been shown to delay the progression of
these complications. Furthermore, an undervalued important element in optimal
management and delaying disease progression is the improvement of education
and awareness regarding diabetes and its complications among both general and
diabetic patients. Focusing on these parameters could enable actions targeting
preventive strategies more effectively, improve patient’s quality of life and con-
sequently, improve the national healthcare systems with significant cost savings.
In that context, our study aims to assess the knowledge, attitude, and practices
(KAP) around diabetic eye disease in the general population including patients
with DM and non-diabetic people in Medina City, Saudi Arabia. To the best of
our knowledge, this is the first study to evaluate KAP regarding diabetic eye dis-
eases among general population in Medina. In addition, as most other studies
focused on DR alone, we opted for a more comprehensive approach to diabetic
eye diseases.

2. Objectives
1) To assess the knowledge, attitude, and practice level regarding diabetic
complications, specifically diabetic eye disease in both diabetic and non-diabetic
people in Medina.
2) To determine the barriers to eye care for diabetic eye disease among the
general population in Medina.

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 H. M. Makhdoum et al.

3. Materials & Methods

3.1. Study Design and Duration
Our study is a cross-sectional study among the general population in Medina
City, which was started in January 2023.

3.2. Study Population and Sampling

The study includes the general population of Medina, either diabetic or
non-diabetic people from both genders. Participants less than 18 years old are
excluded.
Our study sample includes 385 participants, they are selected randomly from
Medina City by using a self-administered online Questionnaire (See Appendix).
The survey was distributed using social media platforms. A non-probability
(convenience) sampling method was used to select the sampling units. For sam-
ple size calculation, we used a (Sampsize) website.

3.3. Survey Instrument

English and Arabic self-administrative online questionnaires are used (See Ap-
pendix). The questionnaire was pretested in a pilot study on 30 participants to
ensure the clarity of the questionnaire and identify any omissions; several addi-
tions and modifications were made.
The questionnaire is divided into four parts: the first includes questions re-
garding patients’ demographic data, such as age, gender, level of education, ma-
rital status, place of residency, associated comorbidities, and smoking status. The
second part includes eight questions to assess the knowledge regarding diabetes
by asking the population about the complications, screening, and treatment op-
tions of diabetic eye disease. The third part contains seven questions to assess the
knowledge, attitude/practice of diabetic eye complications. The last part involves
only people who have diabetes to ask about the background of the disease which
includes type, duration, type of treatment, and last HbA1C. The participants are
asked to choose the most appropriate reason from a list based on their opinions
and knowledge.
Participation of the general population in the study is based on an informed
consent option chosen before the completion of the questionnaire. Participants
are informed about the study’s goal, length, and anonymity before being re-
cruited. The participants are notified that their information will be used for re-
search purposes, but the participants’ identities remain anonymous.

3.4. Data Analysis

The data were collected, reviewed, and then fed to Statistical Package for Social
Sciences version 21 (SPSS: An IBM Company). All statistical methods used were
two-tailed with alpha level of 0.05 considering significance if P value less than or
equal to 0.05. Regarding knowledge and awareness, each correct answer was

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H. M. Makhdoum et al.

given 1-point score. Overall awareness level regarding diabetic eye diseases was
assessed through summing up discrete scores for different correct awareness
items. The overall knowledge score was categorized to poor level if participants’
score was less than 60% of the overall score and good level of knowledge was
considered if the participants score was 60% or more of the overall score. De-
scriptive analysis was done by prescribing frequency distribution and percentage
for study variables including participants’ personal data, education and medical
data, and family history of DM. Also, knowledge and awareness items, attitude
and self-reported practices for eye examination were tabulated while overall
knowledge level was graphed. Cross tabulation for showing distribution of par-
ticipants’ overall knowledge level by their data was carried out with Pearson
chi-square test for significance and exact probability test if there were small fre-
quency distributions.

3.5. Ethical Approval

This study was ethically approved by The Institutional Review Board (IRB),
General Directorate of Health Affairs in Madinah with IRB log No. 23-061.

4. Results
A total of 339 eligible participants completed the study questionnaire. Partici-
pants’ ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6
years old. Exact of 253 (74.6%) were females, 230 (67.8%) were single, and 94
(27.7%) were married. As for education, 185 (54.6%) had a university level of
education, 132 (38.9%) were in high school and 10 (2.9%) had a post-graduate
degree. As for co-morbidities, 32 (9.6%) were diabetic, 21 (6.3%) were hyperten-
sive, 16 (4.8%) had dyslipidemia, 11 (3.3%) had Ischemic Heart Disease (IHD)
while most of the participants (79.1%; 265) had no chronic health problem. A
total of 208 (61.4%) had a family history of DM, 270 (79.6%) were non-smokers,
but 50 (14.7%) were current smokers (Table 1).
Table 2 shows the knowledge about diabetic eye diseases among general pop-
ulation, Medina City, Saudi Arabia. A total of 70 (20.6%) of the study partici-
pants said that they may have DM and not know about it. As for complications
poorly controlled for DM, 90.4% reported for eye diseases, 79.1% know about
Nephropathy, 76.2% for Neuropathy, 70.6% for coronary artery disease, and
70.2% know about Peripheral vascular disease. Only 57.4% know about strokes
as a complication for poor DM control. Regarding the effect of DM on the eye,
56.3% know about the effect on the retina, 53.1% know about the vision affect,
and 38.6% know that DM can affect the health of the eyes, 37.2% know about
blindness. A total of 78.5% know that children with diabetes also have a risk of
developing eye complications, 75.2% know that a diabetic patient needs to have
an eye checkup when his/her blood sugar level is well-controlled, and 90.3%
know that a diabetic patient needs to have an eye checkup when his/her blood
sugar level is poorly controlled. As for check-up frequency, only 22.1% know it

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 H. M. Makhdoum et al.

Table 1. Bio-demographic data of study participants, Medina City, Saudi Arabia (n =

339).

Bio-demographic data No. %

Age in years

18 - 29 237 69.9%

30 - 44 33 9.7%

45 - 59 54 15.9%

>59 15 4.4%

Gender

Male 86 25.4%

Female 253 74.6%

Marital status

Single 230 67.8%

Married 94 27.7%

Divorced/widow 15 4.4%

Educational level

Below high school 12 3.5%

High school 132 38.9%

Bachelor degree 185 54.6%

Post-graduate degree 10 2.9%

Do you have any comorbidities?

No-comorbidities. 265 79.1%

Diabetes Meletus 32 9.6%

Hypertension 21 6.3%

Dyslipidemia 16 4.8%

Ischemic Heart Disease 11 3.3%

Others 23 6.9%

Are there any members in your family who have diabetes?

Yes 208 61.4%

No 131 38.6%

Smoking

Non-smoker 270 79.6%

Ex-smoker 19 5.6%

Current smoker 50 14.7%

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H. M. Makhdoum et al.

Table 2. Knowledge about diabetic eye diseases among general population, Medina City,
Saudi Arabia (n = 339).

Knowledge items No. %

Can you have diabetes and not know it?

Yes 70 20.6%

No 159 46.9%

I don’t know 110 32.4%

Complications poorly controlled for DM

Coronary artery disease 199 70.6%

Strokes 162 57.4%

Peripheral vascular disease 198 70.2%

Neuropathy 215 76.2%

Eye disease 255 90.4%

Nephropathy 223 79.1%

How do you think diabetes can affect the eyes?

No idea 38 11.2%

It doesn’t affect the eyes at all 10 2.9%

Affects vision 180 53.1%

Affects your glasses prescription 53 15.6%

Can make you blind 126 37.2%

Affects the health of the eyes 131 38.6%

Retina is the main part of the eyes that is damaged due

191 56.3%
to diabetes

Others 2 0.6%

Children with diabetes also have a risk of developing

eye complications

Yes 266 78.5%

No 21 6.2%

I don’t know 52 15.3%

Diabetic patient needs to have an eye checkup when

his/her blood sugar level is well-controlled?

Yes 255 75.2%

No 51 15.0%

I don’t know 33 9.7%

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 H. M. Makhdoum et al.

Continued

Diabetic patient needs to have an eye checkup when

his/her blood sugar level is poorly controlled

Yes 306 90.3%

No 11 3.2%

I don’t know 22 6.5%

How often should persons with diabetes get their eyes

tested, if their diabetes is stable?

Only if their vision changes 48 14.2%

Every three months 65 19.2%

Every six months 92 27.1%

Every one year 75 22.1%

Every two years 5 1.5%

I don’t know 54 15.9%

treatments available for diabetic retinopathy

Good control of diabetes alone is adequate 161 47.5%

Laser treatments 110 32.4%

Surgery 67 19.8%

I don’t know 128 37.8%

should be annually. Regarding available treatment for diabetic retinopathy, most

of the participants reported good control of diabetes alone is adequate (47.5%),
followed by laser treatment (32.4%), and surgery (19.8%).
As shown in Figure 1. A total of 112 (33%) of the study participants had an
overall good knowledge of diabetic eye diseases while most of them (67%; 227)
had a poor knowledge level.
Table 3 shows the attitude regarding diabetic eye diseases, among the general
population in Medina City, Saudi Arabia. Exact of 74% disagreed that patients
with diabetes often waste their time and money on eye checkups as most of the
time eyes of diabetics are normal and 72.9% of the study participants disagreed
that if the vision is good, it means that the eyes are not affected due to diabetes.
Hence, no need to visit an eye doctor every year. 71.7% of the participants disa-
greed that if treatment was started for an eye problem, no need to worry about
controlling sugar and lipid. Only 42.8% disagreed that if a diabetic patient was
treated with laser once, no need for laser treatment again in that eye to treat
complications of diabetes.

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H. M. Makhdoum et al.

Figure 1. Overall public knowledge and awareness level about diabetic eye diseases
among general population, Medina City, Saudi Arabia.

Table 3. Attitude regarding diabetic eye diseases among general population, Medina City,
Saudi Arabia (n = 339).

Disagree Neutral Agree

Attitude items
No. % No. % No. %

If the vision is good, it means that the

eyes are not affected due to diabetes.
247 72.9% 31 9.1% 61 18.0%
Hence, no need to visit an eye doctor
every year

If treatment was started for an eye

problem, no need to worry about 243 71.7% 50 14.7% 46 13.6%
controlling sugar & lipid

Patients with diabetes often waste

their time and money on eye checkups
251 74.0% 49 14.5% 39 11.5%
as most of the time eyes of diabetics
are normal

If a diabetic patient was treated

with laser once, no need for laser
145 42.8% 0 0.0% 194 57.2%
treatment again in that eye to treat
complications of diabetes

Table 4 shows the public practice, reasons, and barriers regarding eye exami-
nation among diabetic patients. A total of 11 (34.4%) diabetic patients undergo
annual eye examination while 4 (12.5%) never do. As for reasons that make di-
abetics undergo the first eye screening, the most reported included Self-awareness
(50%), Doctor’s referral (46.9%), and No previous eye screening was done
(9.4%). Regarding the barriers that prevent diabetics from getting eye care, most
of the participants reported No recommendation from the family physician or
diabetologist (46.9%), No ocular symptoms (31.3%), Lack of access to eye care
(15.6%), and Financial reasons (6.3%).

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 H. M. Makhdoum et al.

Table 4. Public practice, reasons and barriers regarding eye examination among diabetic
patients (n = 32).

Practice No. %

How often do you get an eye exam due to your diabetes?

Only if my vision changes 7 21.9%

Every three months 3 9.4%

Every six months 6 18.8%

Every one year 11 34.4%

Every two years 1 3.1%

Never 4 12.5%

Reasons that make you undergo the first eye screening

Self-awareness 16 50.0%

Doctor’s referral 15 46.9%

No previous eye screening was done 3 9.4%

Others 4 12.5%

Barriers that prevent you from getting eye care

No recommendation from the family physician or diabetologist 15 46.9%

No ocular symptoms 10 31.3%

Lack of access to eye care 5 15.6%

Others 3 9.4%

Financial reasons 2 6.3%

As shown in Table 5, a total of 40% of participants aged more than 59 years

had an overall good knowledge level compared to 12.1% of others aged 30 - 44
years with recorded statistical significance (P = 0.001). Also, 40% of single par
ticipants had good knowledge versus 6.7% of widows (P = 0.001). Good know-
ledge about diabetic eye diseases was detected among 37% of participants with a
family history of DM in comparison to 26.7% of others (P = 0.049).
Table 6 shows distribution of public knowledge of diabetic eye diseases by
diabetes data, Medina City, Saudi Arabia. A total of 56.3% of diabetic patients
had type 2 DM. Diabetes was for 6 - 10 years among 28.1% of diabetics, for 11 -
20 among 28.1%, and for less than 5 years among 28.1%. Tablets were the most
received treatment (50%) followed by insulin injection (40.6%), and other.
HbA1c was less than 6.5% among 18.8% of the study diabetics, and > 7.5%
among 53.1%. No relation between diabetic patients and their knowledge of di-
abetic eye diseases was detected (P > 0.05 for all).

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H. M. Makhdoum et al.

Table 5. Factors associated with public knowledge of diabetic eye diseases, Medina City,
Saudi Arabia (n = 339).

Overall knowledge level

Factors Poor Good P-value

No. % No. %

Age in years

18 - 29 144 60.8% 93 39.2%

30 - 44 29 87.9% 4 12.1% 0.001*$

45 - 59 45 83.3% 9 16.7%

>59 9 60.0% 6 40.0%

Gender

Male 63 73.3% 23 26.7% 0.151

Female 164 64.8% 89 35.2%

Marital status

Single 138 60.0% 92 40.0%

0.001*
Married 75 79.8% 19 20.2%

Divorced/widow 14 93.3% 1 6.7%

Educational level

Below high school 11 91.7% 1 8.3%

High school 88 66.7% 44 33.3% 0.217$

Bachelor degree 120 64.9% 65 35.1%

Post-graduate degree 8 80.0% 2 20.0%

Smoking

Non-Smoker 176 65.2% 94 34.8%

0.388
Ex-smoker 14 73.7% 5 26.3%

Current smoker 37 74.0% 13 26.0%

Do you have any eye diseases or

previous eye treatment?
0.871
Yes 77 67.5% 37 32.5%

No 150 66.7% 75 33.3%

Are there any members in your

family who have diabetes?
0.049*
Yes 131 63.0% 77 37.0%

No 96 73.3% 35 26.7%

P: Pearson χ2 test; $: Exact probability test; *P < 0.05 (significant).

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 H. M. Makhdoum et al.

Table 6. Distribution of public knowledge of diabetic eye diseases by diabetes data, Medina City, Saudi Arabia.

Overall knowledge level

Total
Diabetes data Poor Good P-value

No. % No. % No. %

Do you have diabetes?

Yes 32 9.4% 19 8.4% 13 11.6% 0.338

No 307 90.6% 208 91.6% 99 88.4%

Type of DM

Type 1 DM 10 31.3% 6 31.6% 4 30.8%

0.183
Type 2 DM 18 56.3% 9 47.4% 9 69.2%

I don’t know 4 12.5% 4 21.1% 0 0.0%

Duration of DM (years)

<5 9 28.1% 6 31.6% 3 23.1%

6 - 10 9 28.1% 3 15.8% 6 46.2% 0.283

11 - 20 9 28.1% 6 31.6% 3 23.1%

>20 5 15.6% 4 21.1% 1 7.7%

How is your diabetes treated?

Diet control and or exercise 1 3.1% 1 5.3% 0 0.0%

Tablets 16 50.0% 9 47.4% 7 53.8%

0.684
Insulin injections 13 40.6% 7 36.8% 6 46.2%

None-monitoring 1 3.1% 1 5.3% 0 0.0%

Others 1 3.1% 1 5.3% 0 0.0%

Your last HbA1C level?

<6.5% 6 18.8% 3 15.8% 3 23.1%

0.412
6.5% - 7.5% 9 28.1% 7 36.8% 2 15.4%

>7.5% 17 53.1% 9 47.4% 8 61.5%

P: Exact probability test.

5. Discussion
According to the WHO, the number of people with diabetes across the world is
about 280 million, and it is expected to double by 2025 [5]. It’s concerning that
the Middle East and North Africa have a higher prevalence of diabetes compared
to other parts of the world, which puts patients in those regions at a higher risk
of developing complications [10]. The Kingdom of Saudi Arabia is one of the top
10 countries with the highest prevalence of diabetes globally, and this is mainly

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H. M. Makhdoum et al.

due to lifestyle changes [11]. Physical inactivity and a sedentary lifestyle caused
by economic improvement are the main reasons for reduced life expectancy in
the KSA [12].
Diabetes affects the blood vessels in the eyes, leading to various disorders such
as glaucoma, vitreous hemorrhage, cataracts, diabetic retinopathy, and ultimate-
ly blindness. Diabetic retinopathy is the most common eye disorder in people
with diabetes [13].
The current study aimed to assess public awareness, and attitude regarding
diabetic eye disease and to assess eye care practices among diabetics. Regarding
knowledge level, the study showed that about one-third of the participants had
good knowledge about diabetic eye diseases. In more detail, one-fifth of the
study participants reported that they may have DM and not know about it. Re-
garding the complications of poorly controlled DM, eye diseases, nephropathy,
neuropathy, coronary artery disease, and peripheral vascular disease were the
most known. More than half of the participants knew about the effect of DM
on the retina, also knew that DM can affect vision, and more than one-third
talked about the effects on the health of the eyes, and about blindness. About
three-fourths know that children with diabetes also have a risk of developing eye
complications, diabetic patient needs to have an eye checkup when his/her blood
sugar level is well-controlled but most of them know that diabetic patient needs
to have an eye checkup when his/her blood sugar level is poorly controlled. In
regard to check-up frequency, only one-fifth of the participants know it should
be annually. Regarding available treatment for diabetic retinopathy, the most
reported were good control of diabetes, laser treatment, and surgery.
Knowledge level was higher among old-aged participants and those with a
family history of DM. Similar findings were reported by El-Bab et al. [14] in the
city of Al-Madinah where 36.1% of participants were knowledgeable about di-
abetic eye diseases which is similar to our study findings. Relative to the current
study findings, a higher awareness level was reported in Jeddah, [15] where
92.4% of the participants had a satisfactory level of awareness but only 10.5% of
participants knew the recommended frequency for eye check-ups (similar to the
current study finding). Also, Al-Hargan MH et al. [16] in Riyadh documented
that 88% of study participants were aware that diabetes mellitus can affect the
retina; whereas 76% knew that control of blood sugar decreases the hazard of
DR, and 66% were aware that diabetic eye disease can lead to blindness. Another
study in Riyadh by Al Rashed WA et al. [17] revealed that 88.6% of the partici-
pants had high awareness about eye problems in diabetes, ocular trauma
(81.2%), and other general eye diseases (91.3%). This estimated poor awareness
in our study sample may be explained by lack of health education awareness
provided by health care authorities and indicates the high need for periodic health
education campaigns. Globally, Konstantinidis L et al. [7] found that nearly all
participants knew that diabetes could damage the eye; also, most of them were
aware of the importance of glycemic control and regular eye examination in

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 H. M. Makhdoum et al.

preventing eye diseases. Schmid et al. [9] reported that 96% of Australian pa-
tients with diabetes were aware that diabetes could be sight-threatening, and more
than 98% of Japanese patients with type 2 diabetes were aware that diabetes could
be related to eye damage [18]. Improving public awareness about diabetic eye dis-
eases among general population will help in early disease detection and also in
avoiding risky behavior that may contribute to serious eye complications. This
will reduce public burden including economic and daily life burden on disease
cases who may have irreversible eye problems up to blindness which inversely
affect their quality of life.
In regard to participants’ attitudes and perceptions, the current study showed
good attitudes regarding eye care practice for diabetics 74% disagreed that pa-
tients with diabetes often waste their time and money on eye checkups as most
of the time eyes of diabetics are normal, almost the same percentage disagreed
that if vision is good, it disagreed that if the vision is good, it means that the eyes
are not affected due to diabetes. Hence, no need to visit an eye doctor every year,
also, similar number of participants disagreed that if treatment was started for
an eye disagreed that if treatment was started for an eye problem, no need to
worry about controlling sugar and lipids. Less than half of the participants disa-
greed that if a diabetic patient was treated with laser once, there is no need for
laser treatment again in that eye to treat complications of diabetes. These find-
ings were supported by many other studies in Saudi Arabia, [19] [20] [21] and
outside Saudi Arabia [16] [17] [18]. These similar findings regarding the good
attitudes and perceptions about diabetic eye diseases could be attributed to the
higher prevalence of DM in Saudi Arabia and the fear of getting or worsening of
the diabetic eye disease in some patients. Also, high rates of having a family his-
tory with DM can increase the good attitude and perception regarding it.

6. Study Limitations and Suggestions

To the authors’ knowledge, this is the first study in Medina region, Saudi Arabia
to assess the knowledge, attitude, in addition to practices regarding diabetic eye
disease among general population which had a large sample size (385) with a
sufficient response rate. However, in interpreting the results of this study, some
limitations should be considered. The research was carried out in Medina region;
therefore, results may not be generalized to people worldwide. Study sampling
method (Convenience sampling) which was performed through a cross-sectional
survey. As such, the data were collected online through self-reported question-
naires on social media. As a result, there is a possibility of bias against underprivi-
leged populations or those having problems in using electronic devices. Finally,
our study didn’t exclude people who are physicians or have medical back-
grounds which will affect their choices. Therefore, studies from different regions
in Saudi Arabia and studies that exclude physicians and people with medical
backgrounds are suggested because having a medical background and the health
awareness of different regions of Saudi Arabia may affect the results. Despite

DOI: 10.4236/ojoph.2024.141003 31 Open Journal of Ophthalmology

H. M. Makhdoum et al.

these limitations, this study provides useful information regarding diabetic eye
disease knowledge, awareness, and practices among Saudi population and may
provide insights for future research in this field to learn more about this area and
address the aforementioned issues.

7. Conclusion and Recommendations

A poor knowledge and awareness level about diabetic eye diseases has been re-
ported among the general population. Furthermore, positive attitudes and per-
ceptions have been revealed by the participants toward the practice of providing
eye care for diabetics. Among diabetic patients, poor practice toward eye exami-
nation of the diabetic has been found. No family physician/diabetologist advice,
no ocular symptoms, lack of access to eye care, and financial concerns were the
most common barriers that hinder diabetics from receiving eye care. These
findings ensured the need for understanding diabetic eye diseases in both di-
abetics and non-diabetics in Medina region, Saudi Arabia, through public health
campaigns for improving the annual eye check-up by their regular ophthalmol-
ogists. All doctors (general practitioners, family physicians, and ophthalmolo-
gists) in addition to optometrists, health workers, educational authorities, and
policy planners should make a concerted effort to raise awareness of diabetic eye
disease and its negative health effects. This would give them the ability to moni-
tor and control this issue at the primary level of prevention.

Conflicts of Interest
The authors declare no conflicts of interest regarding the publication of this pa-
per.

References
[1] Alharbi, A.M.D. and Alhazmi, A.M.S. (2020) Prevalence, Risk Factors, and Patient
Awareness of Diabetic Retinopathy in Saudi Arabia: A Review of the Literature.
Cureus, 12, e11991. [Link]
[2] Mwangi, M.W., Githinji, G.G. and Githinji, F.W. (2011) Knowledge and Awareness
of Diabetic Retinopathy amongst Diabetic Patients in Kenyatta National Hospital,
Kenya. International Journal of Humanities and Social Science, 1, 140-146.
[3] Almubark, R.A., Althumairi, N.A., Alhamdan, A.A., Alnujaidi, H.Y., Alzayer, R.,
Almubark, S.A., et al. (2022) Socioeconomic and Behavioral Disparities among Di-
abetics in Saudi Arabia: A Nation-Wide Descriptive Study. Diabetes, Metabolic
Syndrome, and Obesity, 15, 2693-2703. [Link]
[4] Alzahrani, S.H., Bakarman, M.A., Alqahtani, S.M., Alqahtani, M.S., Butt, N.S., Sa-
lawati, E.M., et al. (2018) Awareness of Diabetic Retinopathy among People with
Diabetes in Jeddah, Saudi Arabia. Therapeutic Advances in Endocrinology and Me-
tabolism, 9, 103-112. [Link]
[5] Tajunisah, I., Wong, P.S., Tan, L.T., Rokiah, P. and Reddy, S.C. (2011) Awareness of
Eye Complications and Prevalence of Retinopathy in the First Visit to Eye Clinic
among Type 2 Diabetic Patients. International Journal of Ophthalmology, 4, Article
No. 56.

DOI: 10.4236/ojoph.2024.141003 32 Open Journal of Ophthalmology

 H. M. Makhdoum et al.

[6] Najmi, H., Otaif, W., Najmi, M., Basehi, M., Tobaigy, M., Alsalim, W., et al. (2021)
Knowledge, Attitude, and Practice around Diabetic Eye Disease among Diabetic Pa-
tients in Jazan Region, Saudi Arabia. Middle East African Journal of Ophthalmolo-
gy, 28, 123-128.
[7] Konstantinidis, L., Carron, T., de Ancos, E., Chinet, L., Hagon-Traub, I., Zuercher,
E., et al. (2017) Awareness and Practices Regarding Eye Diseases among Patients
with Diabetes: A Cross-Sectional Analysis of the CoDiab-VD Cohort. BMC Endo-
crine Disorders, 17, 56. [Link]
[8] Alghamdi, A.H., Bashir, M., Alghamdi, A.A. and Alghamdi, O.A. (2022) Level of
Knowledge and Awareness about Diabetic Retinopathy among the Population of
the Al Baha Region in Saudi Arabia. Medical Sciences, 26, 1-10.
[Link]
[9] Schmid, K.L., Schmid, L.M. and Pedersen, C. (2003) Knowledge of the Ocular Ef-
fects of Diabetes among the General Population of Australia and the Members of
Diabetes Australia. Clinical and Experimental Optometry, 86, 91-103.
[Link]
[10] Sherif, S. and Sumpio, B.E. (2015) Economics Development and Diabetes Preva-
lence in MENA Countries: Egypt and Saudi Arabia comparison. World Journal of
Diabetes, 6, 304-311. [Link]
[11] Aldebasi, Y., Reddy, P., Nair, V. and Ahmed, M. (2015) Screening for Diabetic Re-
tinopathy: The Optometrist’s Perspective. Clinical Optometry, 2015, 1-14.
[Link]
[12] Kadri, R. (2013) Awareness of Diabetic and Hypertensive Eye Disease in Public. In-
ternational Journal of Biological & Medical Research, 2, 533-535.
[13] Bodunde, O.T. and Odusan, O. (2014) Awareness of Ocular Complications of Di-
abetes among Diabetic Patients in a Tertiary Hospital in Western Nigeria. IOSR
Journal of Dental and Medical Sciences, 13, 9-12.
[Link]
[14] El-Bab, M., Shawky, N., Al-Sisi, A. and Akhtar, M. (2012) Retinopathy and Risk
Factors in Diabetic Patients from Al-Madinah Al-Munawarah in the Kingdom of
Saudi Arabia. Clinical Ophthalmology, 6, 269-276.
[Link]
[15] Fallatah, M.O. (2018) Knowledge, Awareness, and Eye Care-Seeking Behavior in
Diabetic Retinopathy: A Cross-Sectional Study in Jeddah, Kingdom of Saudi Arabia.
Ophthalmology and Therapy, 7, 377-385.
[Link]
[16] Al Hargan, M.H., Al Baker, K.M., Al Fadhel, A.A., Al Ghamdi, M.A., Al Muammar,
S.M. and Al Dawood, H.A. (2019) Awareness, Knowledge, and Practices Related to
Diabetic Retinopathy among Diabetic Patients in Primary Healthcare Centers at
Riyadh, Saudi Arabia. Journal of Family Medicine and Primary Care, 8, 373-377.
[Link]
[17] Al Rashed, W.A., Bin Abdulrahman, A.K., Zarban, A.A., Almasri, M.S., Mirza, A.S.
and Khandekar, R. (2017) Public Awareness Regarding Common Eye Diseases
among Saudi Adults in Riyadh City: A Quantitative Study. Journal of Ophthalmol-
ogy, 2017, Article ID 9080791. [Link]
[18] Funatsu, H., Hori, S., Shimizu, E. and Nakamura, S. (2003) Questionnaire Survey on
Periodic Ocular Examination in Japanese Diabetic Patients. American Journal of
Ophthalmology, 136, 955-957. [Link]
[19] Abu-Amara, T.B., Al Rashed, W.A., Khandekar, R., Qabha, H.M., Alosaimi, F.M.,

DOI: 10.4236/ojoph.2024.141003 33 Open Journal of Ophthalmology

H. M. Makhdoum et al.

Alshuwayrikh, A.A., Almadi, M.K. and Alfaris, A. (2019) Knowledge, Attitude and
Practice among Non-Ophthalmic Health Care Providers Regarding Eye Manage-
ment of Diabetics in Private Sector of Riyadh, Saudi Arabia. BMC Health Services
Research, 19, Article No. 375. [Link]
[20] Al Zarea, B.K. (2016) Knowledge, Attitude and Practice of Diabetic Retinopathy
amongst the Diabetic Patients of Aljouf and Hail Province of Saudi Arabia. Journal
of Clinical and Diagnostic Research, 10, NC05-NC08.
[Link]
[21] Al-Asbali, T., Aldawari, S.A., Alzahim, I.A., Alalawi, H., Khandekar, R. and Lotfy,
N.M. (2020) Knowledge, Attitude and Practice Regarding Diabetic Retinopathy
Screening and Its Management among Diabetic Patients at a Private Hospital of
Riyadh, Saudi Arabia. Saudi Journal of Ophthalmology, 34, 85.

DOI: 10.4236/ojoph.2024.141003 34 Open Journal of Ophthalmology

 H. M. Makhdoum et al.

Appendices
English Questionnaire
Section 1: Demographic Part
Question 1: What is your age?
• <18 years
• 18 - 29 years
• 30 - 44 years
• 45 - 59 years
• ≥60 years
Question 2: What is your gender?
• Female
• Male
Question 3: Marital Status?
• Married
• Single
• Divorced
• Widow
Question 4: City?
• Medina
• Other (please specify)……………………………………………………………
Question 5: What is the highest level of education you have completed?
• I did not receive a formal education.
• Elementary
• Intermediate
• High school
• Bachelor’s degree
• Postgraduate
Question 6: Do you have any comorbidities? (Circle one or more of the
following options)
• No, I do not have any comorbidities.
• DM
• HTN
• Dyslipidemia
• IHD
• Other (please specify)……………………………………………………………
Question 7: Smoking status
• Current smoker
• Ex-smoker
• Non-smoker
Question 8: Do you have any eye diseases or previous eye treatment?
• Yes (mention it)…………………………………………………………………
• No
Question 9: Are there any members in your family who have diabetes?

DOI: 10.4236/ojoph.2024.141003 35 Open Journal of Ophthalmology

H. M. Makhdoum et al.

• Yes
• No

Section 2: Assess the Knowledge

Question 1: Can you have diabetes and not know it?
• Yes
• No
• I do not know
Question 2: Which of the following complication/s may arise if diabetes is
poorly controlled?
• Coronary artery disease
○ Yes
○ No
○ I do not know
• Stroke
○ Yes
○ No
○ I do not know
• Peripheral vascular disease
○ Yes
○ No
○ I do not know
• Neuropathy
○ Yes
○ No
○ I do not know
• Eye Disease
○ Yes
○ No
○ I do not know
• Nephropathy
○ Yes
○ No
○ I do not know
Question 3: How do you think diabetes can affect the eyes? (Circle one or
more of the following options)
• No idea
• It doesn’t affect the eyes at all.
• Affects vision.
• Affects your glasses prescription.
• Can make you blind.
• Affects the health of the eyes.
• Retina is the main part of the eyes that is damaged due to diabetes.
• Other (please specify)……………………………………………………………

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 H. M. Makhdoum et al.

Question 4: Children with diabetes also have a risk of developing eye

complications.
• Yes
• No
• I do not know
Question 5: Does a diabetic patient need to have an eye checkup when
his/her blood sugar level is well-controlled?
• Yes
• No
• I do not know
Question 6: Does a diabetic patient need to have an eye checkup when
his/her blood sugar level is poorly controlled?
• Yes
• No
• I do not know
Question 7: How often should persons with diabetes get their eyes tested,
if their diabetes is stable?
• Do not know.
• Only if their vision changes
• Every three months
• Every six months
• Every one year
• Every two years
Question 8: Do you know what are the treatments available for diabetic
retinopathy? (Circle one or more of the following options):
• Good control of diabetes alone is adequate.
• Laser treatments
• Surgery
• I do not know.

Section 3: Assess the Attitude/Practice of Diabetic Eye Diseases

Question 1: If the vision is good, it means that the eyes are not affected
due to diabetes. Hence, no need to visit an eye doctor every year.
• I agree.
• I do not agree.
• I do not know.
Question 2: If treatment was started for an eye problem, no need to worry
about controlling sugar & lipid.
• I agree.
• I do not agree.
• I do not know.
Question 3: Patients with diabetes often waste their time and money on
eye checkups as most of the time eyes of diabetics are normal.
• I agree.

DOI: 10.4236/ojoph.2024.141003 37 Open Journal of Ophthalmology

H. M. Makhdoum et al.

• I do not agree.
• I do not know.
Question 4: How often do you get an eye exam due to your diabetes?
• Never.
• Only if my vision changes.
• Every three months.
• Every six months.
• Every one year.
• Every two years.
• Other (please specify)……………………………………………………………
Question 5: If a diabetic patient was treated with laser once, no need for
laser treatment again in that eye to treat complications of diabetes.
• I agree.
• I do not agree.
• I do not know.
Question 6: What are the reasons that make you undergo the first eye
screening? (Circle one or more of the following options):
• Doctor’s referral.
• Self-awareness.
• No previous eye screening was done.
• Other (please specify)……………………………………………………………
Question 7: What are the barriers that prevent you from getting eye care?
(Circle one or more of the following options):
• No recommendation from the family physician or diabetologist.
• Financial reasons.
• Lack of access to eye care.
• No ocular symptoms.
• Other (please specify)……………………………………………………………
If you do not have diabetes, this survey is finished.

Section 4: Background of Diabetic Patients

Question 1: Do you have diabetes?
• Yes
• No
Question 2: If yes, what type of diabetes do you have, or have you had?
• Type 1
• Type 2
• I do not know
Question 3: Duration of diabetes?
• Less than 5 years
• 6 - 10 years
• 11 - 20 years
• More than 20 years
Question 4: How is/was your diabetes treated?

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 ‫‪H. M. Makhdoum et al.‬‬

‫‪• Insulin injections‬‬

‫‪• Tablets‬‬
‫‪• Diet control and/or exercise‬‬
‫‪• None-monitoring‬‬
‫……………………………………………………………)‪• Other (please specify‬‬
‫?‪Question 5: Your last HbA1C level‬‬
‫‪• <6.5‬‬
‫‪• 6.5 - 7.5‬‬
‫‪• >7.5‬‬
‫‪• I do not know.‬‬
‫‪Thank you for completing the survey.‬‬

‫‪/‬اﻻﺳﺘﺒﯿﺎن ﺑﺎﻟﻠﻐﺔ اﻟﻌﺮﺑﯿﺔ‪Arabic Questionnaire‬‬

‫اﻟﻘﺴﻢ ‪ :1‬اﻟﻤﻌﻠﻮﻣﺎت اﻟﺸﺨﺼﯿﺔ‪.‬‬

‫اﻟﺴﺆال ‪ :1‬ﻣﺎ ھﻮ ﻋﻤﺮك؟‬
‫‪ 18‬ﺳﻨﮫ‪• <.‬‬
‫‪ 29-18‬ﺳﻨﮫ‪• .‬‬
‫‪ 44-30‬ﺳﻨﮫ‪• .‬‬
‫‪ 59-45‬ﺳﻨﮫ‪• .‬‬
‫‪ 60‬ﺳﻨﮫ‪• >.‬‬
‫اﻟﺴﺆال ‪ :2‬ﻣﺎ ھﻮ ﺟﻨﺴﻚ؟‬
‫اﻧﺜﻰ‪• .‬‬
‫ذﻛﺮ‪• .‬‬
‫اﻟﺴﺆال ‪ :3‬اﻟﺤﺎﻟﺔ اﻻﺟﺘﻤﺎﻋﯿﺔ؟‬
‫ﻣﺘﺰوج‪/‬ه‪• .‬‬
‫أﻋﺰب‪/‬ﻋﺰﺑﺎء‪• .‬‬
‫ﻣﻄﻠﻖ‪/‬ه‪• .‬‬
‫أرﻣﻞ‪/‬ه‪• .‬‬
‫اﻟﺴﺆال ‪ :4‬ﻣﻜﺎن اﻹﻗﺎﻣﺔ؟‬
‫اﻟﻤﺪﯾﻨﺔ اﻟﻤﻨﻮرة‪• .‬‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ................................................................................................‬‬
‫اﻟﺴﺆال ‪ :5‬اﻟﻤﺴﺘﻮى اﻟﺘﻌﻠﯿﻤﻲ؟‬
‫ﻟﻢ اﺣﺼﻞ ﻋﻠﻰ أي درﺟﺔ ﻋﻠﻤﯿﺔ‪• .‬‬
‫اﻻﺑﺘﺪاﺋﯿﺔ‪• .‬‬
‫اﻟﻤﺘﻮﺳﻄﺔ‪• .‬‬
‫اﻟﺜﺎﻧﻮﯾﺔ‪• .‬‬
‫•‬ ‫اﻟﺒﻜﺎﻟﻮرﯾﻮس‪.‬‬
‫دراﺳﺎت ﻋﻠﯿﺎ •‬
‫اﻟﺴﺆال ‪ :6‬ھﻞ ﺗﻌﺎﻧﻲ‪/‬ن ﻣﻦ أي ﻣﺸﺎﻛﻞ ﺻﺤﯿﺔ؟‬
‫)اﺧﺘﺮ واﺣﺪ او أﻛﺜﺮ ﻣﻦ اﻟﺨﯿﺎرات اﻟﺘﺎﻟﯿﺔ(‪:‬‬
‫أﻧﺎ ﻻ أﻋﺎﻧﻲ ﻣﻦ أي ﻣﺸﺎﻛﻞ ﺻﺤﯿﺔ‪• .‬‬
‫داء اﻟﺴﻜﺮي‪• .‬‬
‫ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم‪• .‬‬

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‫‪H. M. Makhdoum et al.‬‬

‫ارﺗﻔﺎع ﻧﺴﺒﺔ اﻷﺣﻤﺎض اﻟﺪھﻨﯿﺔ )اﻟﺪھﻮن( ﻓﻲ اﻟﺠﺴﻢ‪• .‬‬

‫أﻣﺮاض اﻟﻘﻠﺐ‪• .‬‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ................................................................................................‬‬
‫اﻟﺴﺆال ‪ :7‬ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺎﻟﺘﺪﺧﯿﻦ‪ ،‬ھﻞ اﻧﺖ؟‬
‫ﻣﺪﺧﻦ‪/‬ة‪• .‬‬
‫ﻣﺪﺧﻦ‪/‬ه ﺳﺎﺑﻘﺎ ً‪• .‬‬
‫ﻏﯿﺮ ﻣﺪﺧﻦ‪/‬ة‪• .‬‬
‫اﻟﺴﺆال ‪ :8‬ھﻞ ﺗﻌﺎﻧﻲ‪/‬ن ﻣﻦ أي أﻣﺮاض ﺑﺎﻟﻌﯿﻦ أو ﺳﺒﻖ ﻟﻚ اﻟﺤﺼﻮل ﻋﻠﻰ ﻋﻼج ﻟﻠﻌﯿﻦ؟‬
‫ﻧﻌﻢ )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ...................................................................................................‬‬
‫ﻻ •‬
‫اﻟﺴﺆال ‪ :9‬ھﻞ ﯾﻌﺎﻧﻲ أﺣﺪ اﻓﺮاد ﻋﺎﺋﻠﺘﻚ ﻣﻦ داء اﻟﺴﻜﺮي؟‬
‫•‬ ‫ﻧﻌﻢ‬
‫ﻻ •‬

‫اﻟﻘﺴﻢ ‪ :2‬ﺗﻘﯿﯿﻢ اﻟﻤﻌﻠﻮﻣﺎت‪.‬‬

‫اﻟﺴﺆال ‪ :1‬ھﻞ ﻣﻦ اﻟﻤﻤﻜﻦ أن ﺗﻜﻮن‪/‬ي ﻣﺼﺎﺑﺔ ﺑﺪاء اﻟﺴﻜﺮي دون أن ﺗﻌﻠﻢ‪/‬ي؟‬
‫ﻧﻌﻢ •‬
‫ﻻ •‬
‫ﻻ اﻋﻠﻢ •‬
‫اﻟﺴﺆال ‪ :2‬أي ﻣﻦ اﻟﻤﻀﺎﻋﻔﺎت أو اﻟﻤﺸﺎﻛﻞ اﻟﺼﺤﯿﺔ اﻟﺘﺎﻟﯿﺔ ﯾﻤﻜﻦ ان ﯾﻨﺘﺞ ﺑﺴﺒﺐ ﺿﻌﻒ اﻟﺘﺤﻜﻢ‬
‫ﺑﺎﻟﺴﻜﺮي؟‬
‫•‬ ‫أﻣﺮاض ﺷﺮاﯾﯿﻦ اﻟﻘﻠﺐ‬
‫ﻧﻌﻢ ○‬
‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫•‬ ‫اﻟﺠﻠﻄﺎت اﻟﺪﻣﺎﻏﯿﺔ‬
‫ﻧﻌﻢ ○‬
‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫أﻣﺮاض اﻷوﻋﯿﺔ اﻟﺪﻣﻮﯾﺔ •‬
‫ﻧﻌﻢ ○‬
‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫أﻣﺮاض اﻻﻋﺼﺎب •‬
‫ﻧﻌﻢ ○‬
‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫أﻣﺮاض اﻟﻌﯿﻮن •‬
‫ﻧﻌﻢ ○‬
‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫أﻣﺮاض اﻟﻜﻠﻰ •‬
‫ﻧﻌﻢ ○‬

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 ‫‪H. M. Makhdoum et al.‬‬

‫ﻻ ○‬
‫ﻻ اﻋﻠﻢ ○‬
‫اﻟﺴﺆال ‪ :3‬ﺑﺎﻋﺘﻘﺎدك‪ ،‬ﻛﯿﻒ ﯾﻤﻜﻦ ﻟﺪاء اﻟﺴﻜﺮي ان ﯾﺆﺛﺮ ﻋﻠﻰ اﻟﻌﯿﻦ؟‬
‫)اﺧﺘﺮ واﺣﺪ او أﻛﺜﺮ ﻣﻦ اﻟﺨﯿﺎرات اﻟﺘﺎﻟﯿﺔ(‪:‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫ﻻ ﯾﺆﺛﺮ ﻋﻠﻰ اﻟﻌﯿﻦ ﻣﻄﻠﻘﺎ ً‪• .‬‬
‫ﯾﺆﺛﺮ ﻋﻠﻰ اﻟﺮؤﯾﺔ‪• .‬‬
‫ﯾﺆﺛﺮ ﻋﻠﻰ ﻗﯿﺎﺳﺎت اﻟﻨﻈﺎرة‪• .‬‬
‫ﻗﺪ ﯾﺆدي اﻟﻰ اﻟﻌﻤﻰ‪• .‬‬
‫ﯾﺆﺛﺮ ﻋﻠﻰ ﺻﺤﺔ اﻟﻌﯿﻦ‪• .‬‬
‫اﻟﺸﺒﻜﯿﺔ ھﻲ اﻟﺠﺰء اﻷﺳﺎﺳﻲ ﻣﻦ اﻟﻌﯿﻦ اﻟﺬي ﯾﺘﺄﺛﺮ ﺑﺴﺒﺐ داء اﻟﺴﻜﺮي‪• .‬‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ...............................................................................................‬‬
‫اﻟﺴﺆال ‪ :4‬ھﻞ ﺗﻌﺘﻘﺪ‪/‬ي ان اﻷطﻔﺎل اﻟﻤﺼﺎﺑﯿﻦ ﺑﺪاء اﻟﺴﻜﺮي ﻟﺪﯾﮭﻢ اﻟﺨﻄﻮرة ﻟﻺﺻﺎﺑﺔ ﺑﻤﻀﺎﻋﻔﺎت‬
‫وﻣﺸﺎﻛﻞ اﻟﻌﯿﻦ أﯾﻀﺎً؟‬
‫ﻧﻌﻢ •‬
‫•‬ ‫ﻻ‬
‫ﻻ اﻋﻠﻢ •‬
‫اﻟﺴﺆال ‪ :5‬ھﻞ ﺗﻌﺘﻘﺪ‪/‬ي ان ﻣﺮﯾﺾ اﻟﺴﻜﺮي ﯾﺤﺘﺎج اﻟﻰ اﻟﻘﯿﺎم ﺑﻔﺤﺺ اﻟﻌﯿﻦ ﺑﺸﻜﻞ دوري ﻋﻨﺪﻣﺎ ﯾﻜﻮن‬
‫ﻣﺴﺘﻮى اﻟﺴﻜﺮ ﻟﺪﯾﮫ ﻣﻨﺘﻈﻢ؟‬
‫ﻧﻌﻢ •‬
‫•‬ ‫ﻻ‬
‫ﻻ اﻋﻠﻢ •‬
‫اﻟﺴﺆال ‪ :6‬ھﻞ ﺗﻌﺘﻘﺪ‪/‬ي ان ﻣﺮﯾﺾ اﻟﺴﻜﺮي ﯾﺤﺘﺎج اﻟﻰ اﻟﻘﯿﺎم ﺑﻔﺤﺺ اﻟﻌﯿﻦ ﺑﺸﻜﻞ دوري ﻋﻨﺪﻣﺎ ﯾﻜﻮن‬
‫ﻣﺴﺘﻮى اﻟﺴﻜﺮ ﻟﺪﯾﮫ ﻏﯿﺮ ﻣﻨﺘﻈﻢ؟‬
‫ﻧﻌﻢ •‬
‫•‬ ‫ﻻ‬
‫ﻻ اﻋﻠﻢ •‬
‫اﻟﺴﺆال ‪ :7‬ﺑﺎﻋﺘﻘﺎدك‪ ،‬ﻛﻢ ﻣﺮه ﯾﺠﺐ ﻋﻠﻰ ﻣﺮﯾﺾ اﻟﺴﻜﺮي ان ﯾﻘﻮم ﺑﻔﺤﺺ اﻟﻌﯿﻦ ﻓﻲ ﺣﺎل ﻛﺎن ﻣﺴﺘﻮى‬
‫اﻟﺴﻜﺮ ﻟﺪﯾﮫ ﻣﻨﺘﻈﻢ؟‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫ﻓﻘﻂ ﻓﻲ ﺣﺎل وﺟﻮد ﺗﻐﯿﯿﺮات ﻓﻲ اﻟﺮؤﯾﺔ‪• .‬‬
‫ﻣﺮه واﺣﺪة ﻛﻞ ﺛﻼﺛﺔ أﺷﮭﺮ‪• .‬‬
‫ﻣﺮه واﺣﺪة ﻛﻞ ﺳﺘﺔ أﺷﮭﺮ‪• .‬‬
‫ﻣﺮه واﺣﺪة ﻛﻞ ﺳﻨﮫ‪• .‬‬
‫ﻣﺮه واﺣﺪة ﻛﻞ ﺳﻨﺘﯿﻦ‪• .‬‬
‫اﻟﺴﺆال ‪ :8‬ھﻞ ﺗﻌﻠﻢ‪/‬ي ﻣﺎ ھﻲ طﺮق اﻟﻌﻼج اﻟﻤﺘﻮﻓﺮة ﻟﻌﻼج اﻋﺘﻼل اﻟﺸﺒﻜﯿﺔ اﻟﻤﺮﺗﺒﻂ ﺑﺪاء اﻟﺴﻜﺮي؟‬
‫)اﺧﺘﺮ واﺣﺪ او أﻛﺜﺮ ﻣﻦ اﻟﺨﯿﺎرات اﻟﺘﺎﻟﯿﺔ(‪:‬‬
‫اﻟﺘﺤﻜﻢ اﻟﺠﯿﺪ ﺑﻤﺴﺘﻮى اﻟﺴﻜﺮ وﺣﺪه ﯾُﻌﺪ ﻛﺎﻓﯿﺎ ً‪• .‬‬
‫اﻟﻌﻼج ﺑﺎﻟﻠﯿﺰر‪• .‬‬
‫اﻟﺠﺮاﺣﺔ‪• .‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬

‫‪ :‬ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺎﻟﺴﻠﻮك واﻟﻤﻤﺎرﺳﺎت ﻟﻤﻀﺎﻋﻔﺎت ﻣﺮض اﻟﺴﻜﺮي ﻓﻲ اﻟﻌﯿﻨﯿﻦ ‪3.‬اﻟﻘﺴﻢ‬

‫اﻟﺴﺆال ‪ :1‬إذا ﻛﺎﻧﺖ اﻟﺮؤﯾﺔ ﺟﯿﺪة‪ ،‬ﻓﮭﺬا ﯾﻌﻨﻲ أن اﻟﻌﯿﻨﯿﻦ ﻟﻢ ﺗﺘﺄﺛﺮ ﺑﺎﻟﺴﻜﺮي وﻟﺬﻟﻚ ﻻ ﺣﺎﺟﮫ ﻟﺰﯾﺎرة طﺒﯿﺐ‬

‫‪DOI: 10.4236/ojoph.2024.141003‬‬ ‫‪41‬‬ ‫‪Open Journal of Ophthalmology‬‬

‫‪H. M. Makhdoum et al.‬‬

‫اﻟﻌﯿﻮن ﺳﻨﻮﯾﺎ ً ﻟﻠﻘﯿﺎم ﺑﻔﺤﺺ اﻟﻌﯿﻦ؟‬

‫أواﻓﻖ‪• .‬‬
‫ﻻ أواﻓﻖ‪• .‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫اﻟﺴﺆال ‪ :2‬ﻓﻲ ﺣﺎل اﺳﺘﺨﺪام أي ﻣﻦ اﻟﻄﺮق اﻟﻌﻼﺟﯿﺔ ﻟﻤﺸﺎﻛﻞ اﻟﻌﯿﻦ‪ ،‬ﻓﻠﯿﺲ ھﻨﺎك داعٍ ﻟﻠﻘﻠﻖ ﺗﺠﺎه اﻟﺘﺤﻜﻢ‬
‫ﺑﻤﺴﺘﻮى اﻟﺴﻜﺮ أو اﻟﺪھﻮن ﻓﻲ اﻟﺠﺴﻢ؟‬
‫أواﻓﻖ‪• .‬‬
‫ﻻ أواﻓﻖ‪• .‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫اﻟﺴﺆال ‪ :3‬ﻏﺎﻟﺒﺎ ً ﻣﺎ ﯾﻘﻮم ﻣﺮﺿﻰ اﻟﺴﻜﺮي ﺑﺘﻀﯿﯿﻊ وﻗﺘﮭﻢ وأﻣﻮاﻟﮭﻢ ﻟﻌﻤﻞ ﻓﺤﻮﺻﺎت اﻟﻌﯿﻦ اﻟﺪورﯾﺔ ﺣﯿﺚ‬
‫إﻧﮫ ﻓﻲ ﻣﻌﻈﻢ اﻷوﻗﺎت ﺗﻜﻮن ﻋﯿﻮﻧﮭﻢ طﺒﯿﻌﯿﺔ وﺑﻼ ﻣﺸﺎﻛﻞ؟‬
‫أواﻓﻖ‪• .‬‬
‫ﻻ أواﻓﻖ‪• .‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫اﻟﺴﺆال ‪ :4‬ﻛﻢ ﻣﺮه ﺗﻘﻮم ﺑﺰﯾﺎرة طﺒﯿﺐ اﻟﻌﯿﻮن ﻟﻔﺤﺺ اﻟﻌﯿﻦ ﺑﺴﺒﺐ ﻣﺮض اﻟﺴﻜﺮي؟‬
‫أﺑﺪاً‪• .‬‬
‫ﻓﻘﻂ ﻓﻲ ﺣﺎل ﻛﺎﻧﺖ ﻟﺪي ﺗﻐﯿﯿﺮات ﻓﻲ اﻟﺮؤﯾﺔ‪• .‬‬
‫ﻣﺮه واﺣﺪه ﻛﻞ ﺛﻼﺛﺔ أﺷﮭﺮ‪• .‬‬
‫ﻣﺮه واﺣﺪه ﻛﻞ ﺳﺘﺔ أﺷﮭﺮ‪• .‬‬
‫ﻣﺮه واﺣﺪه ﺳﻨﻮﯾﺎ ً‪• .‬‬
‫ﻣﺮه واﺣﺪه ﻛﻞ ﺳﻨﺘﯿﻦ‪• .‬‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ...............................................................................................‬‬
‫اﻧﮫ ﻻ ﺣﺎﺟﮫ إﻟﻰ اﻟﻌﻼج اﻟﺴﺆال ‪ :5‬ﻓﻲ ﺣﺎل ﺗﻠﻘﻰ ﻣﺮﯾﺾ اﻟﺴﻜﺮي اﻟﻌﻼج ﺑﺎﻟﻠﯿﺰر ﻣﺮه واﺣﺪة‪ ،‬ﻓﮭﺬا ﯾﻌﻨﻲ‬
‫ﺑﺎﻟﻠﯿﺰر ﻣﺮه أﺧﺮى ﻟﻌﻼج ﻣﻀﺎﻋﻔﺎت وﻣﺸﺎﻛﻞ اﻟﻌﯿﻦ اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺴﻜﺮي؟‬
‫أواﻓﻖ‪• .‬‬
‫ﻻ أواﻓﻖ‪• .‬‬
‫ﻻ اﻋﻠﻢ‪• .‬‬
‫اﻟﺴﺆال ‪ :6‬ﻣﺎ ھﻲ اﻷﺳﺒﺎب اﻟﺘﻲ ﺟﻌﻠﺘﻚ ﺗﻘﻮم‪/‬ي ﺑﺄول ﻓﺤﺺ ﻟﻠﻌﯿﻦ؟‬
‫)اﺧﺘﺮ واﺣﺪ او أﻛﺜﺮ ﻣﻦ اﻟﺨﯿﺎرات اﻟﺘﺎﻟﯿﺔ(‪:‬‬
‫ﺗﺤﻮﯾﻞ اﻟﻄﺒﯿﺐ‪• .‬‬
‫اﻟﻮﻋﻲ اﻟﺬاﺗﻲ‪• .‬‬
‫ﻟﻢ ﯾﺘﻢ ﻋﻤﻞ ﻓﺤﺺ ﻟﻠﻌﯿﻨﯿﻦ •‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• ................................................................................................‬‬
‫اﻟﺴﺆال ‪ :7‬ﻣﺎ ھﻲ اﻟﺤﻮاﺟﺰ أو اﻷﺳﺒﺎب اﻟﺘﻲ ﻣﻨﻌﺘﻚ ﻣﻦ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻌﻨﺎﯾﺔ ﺑﺎﻟﻌﯿﻦ واﻟﻘﯿﺎم ﺑﺎﻟﻔﺤﻮﺻﺎت‬
‫اﻟﺪورﯾﺔ؟‬
‫)اﺧﺘﺮ واﺣﺪ او أﻛﺜﺮ ﻣﻦ اﻟﺨﯿﺎرات اﻟﺘﺎﻟﯿﺔ(‪:‬‬
‫ﻟﻢ ﯾﻜﻦ ھﻨﺎك ﺗﻮﺻﯿﺎت ﻣﻮﺟﮭﮫ ﻣﻦ اﻟﻄﺒﯿﺐ اﻟﺬي اﺗﺎﺑﻊ ﺣﺎﻟﺘﻲ ﻣﻌﮫ‪• .‬‬
‫أﺳﺒﺎب ﻣﺎدﯾﺔ )ﻣﺎﻟﯿﺔ(‪• .‬‬
‫ﻋﺪم اﻟﻘﺪرة ﻋﻠﻰ اﻟﻮﺻﻮل ﻷﻣﺎﻛﻦ اﻟﻌﻨﺎﯾﺔ وﻓﺤﺺ اﻟﻌﯿﻦ‪• .‬‬
‫ﻋﺪم وﺟﻮد أي أﻋﺮاض ﺑﺼﺮﯾﺔ ﺗﺴﺘﺪﻋﻲ اﻟﻘﯿﺎم ﺑﺎﻟﻔﺤﻮﺻﺎت‪• .‬‬
‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪• .................................................................................................‬‬
‫ﻓﻲ ﺣﺎل ﻟﻢ ﺗﻜﻦ‪/‬ﺗﻜﻮﻧﻲ ﻣﺼﺎب‪/‬ه ﺑﺪاء اﻟﺴﻜﺮي‪ ،‬ﻓﺈن ھﺬه اﻻﺳﺘﺒﺎﻧﺔ ﻗﺪ اﻧﺘﮭﺖ‪.‬‬
‫ﺷﻜﺮاً ﻟﻚ ﻋﻠﻰ وﻗﺘﻚ‪.‬‬

‫‪DOI: 10.4236/ojoph.2024.141003‬‬ ‫‪42‬‬ ‫‪Open Journal of Ophthalmology‬‬

 ‫‪H. M. Makhdoum et al.‬‬

‫ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺎﻟﻤﻌﺮﻓﺔ ﻟﺪى ﻣﺮﯾﺾ اﻟﺴﻜﺮي‪4.‬اﻟﻘﺴﻢ‬

‫اﻟﺴﺆال ‪ :1‬ھﻞ اﻧﺖ ﻣﺼﺎب‪/‬ه ﺑﺪاء اﻟﺴﻜﺮي؟‬
‫•‬ ‫ﻧﻌﻢ‬
‫•‬ ‫ﻻ‬
‫اﻟﺴﺆال ‪ :2‬ﻓﻲ ﺣﺎل ﻛﺎﻧﺖ اﺟﺎﺑﺘﻚ ﻟﻠﺴﺆال اﻟﺴﺎﺑﻖ ﺑـ)ﻧﻌﻢ(‪ ،‬ﻓﻤﺎ ھﻮ ﻧﻮع اﻟﺴﻜﺮي اﻟﺬي ﻟﺪﯾﻚ؟‬
‫•‬ ‫اﻟﻨﻮع اﻷول‪.‬‬
‫•‬ ‫اﻟﻨﻮع اﻟﺜﺎﻧﻲ‪.‬‬
‫•‬ ‫ﻻ اﻋﻠﻢ‪.‬‬
‫اﻟﺴﺆال ‪ :3‬ﻣﺎ ھﻲ اﻟﻤﺪة ﻣﻨﺬ أن ﺗﻢ ﺗﺸﺨﯿﺼﻚ ﺑﺪاء اﻟﺴﻜﺮي؟‬
‫•‬ ‫أﻗﻞ ﻣﻦ ‪ 5‬ﺳﻨﻮات‪.‬‬
‫•‬ ‫‪ 10-6‬ﺳﻨﻮات‪.‬‬
‫•‬ ‫‪ 20-11‬ﺳﻨﮫ‪.‬‬
‫•‬ ‫أﻛﺜﺮ ﻣﻦ ‪ 20‬ﺳﻨﮫ‪.‬‬
‫اﻟﺴﺆال ‪ :4‬ﻣﺎ طﺮﯾﻘﺔ اﻟﻌﻼج اﻟﺤﺎﻟﯿﺔ اﻟﺘﻲ ﺗﺴﺘﺨﺪﻣﮭﺎ‪/‬ﺗﺴﺘﺨﺪﻣﯿﮭﺎ ﻟﻌﻼج اﻟﺴﻜﺮي؟‬
‫•‬ ‫إﺑﺮ اﻹﻧﺴﻮﻟﯿﻦ‪.‬‬
‫•‬ ‫أﻗﺮاص دواﺋﯿﺔ )ﺣﺒﻮب(‪.‬‬
‫•‬ ‫اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ واﻟﺮﯾﺎﺿﺔ‪.‬‬
‫•‬ ‫ﻻ اﺳﺘﺨﺪم أي طﺮﯾﻘﺔ ﻋﻼﺟﯿﺔ‪.‬‬
‫•‬ ‫أﺧﺮى )اذﻛﺮھﺎ‪/‬اذﻛﺮﯾﮭﺎ( ‪..............................................................................................‬‬
‫اﻟﺴﺆال ‪ :5‬ﻛﻢ ﻛﺎن ﻣﻌﺪل اﻟﺴﻜﺮ اﻟﺘﺮاﻛﻤﻲ ﻟﺪﯾﻚ ﻓﻲ اﺧﺮ ﺗﺤﻠﯿﻞ؟‬
‫•‬ ‫> ‪6.5‬‬
‫•‬ ‫‪7.5 - 6.5‬‬
‫•‬ ‫< ‪7.5‬‬
‫•‬ ‫ﻻ اﻋﻠﻢ‬
‫ﺷﻜﺮاً ﻟﻚ ﻟﺘﻌﺒﺌﺔ ھﺬه اﻻﺳﺘﺒﺎﻧﺔ‪.‬‬

‫‪DOI: 10.4236/ojoph.2024.141003‬‬ ‫‪43‬‬ ‫‪Open Journal of Ophthalmology‬‬