Evaluation of Diabetic Retinopathy Screening and Management Practices at State Eye Hospitals in South East and South West Nigeria

Diabetic retinopathy is a leading cause of preventable blindness in Nigerian adults, and the quality of its screening and management in state ophthalmic facilities varies significantly across geopolitical zones. This study evaluates the current practices for diabetic retinopathy screening and management at state eye hospitals in Enugu State (South East) and Osun State (South West), identifying gaps and enablers for programme strengthening. A mixed-methods evaluation is conducted at two state eye hospitals, combining structured audits of 200 diabetic patient case records for fundoscopy documentation, screening interval compliance, retinopathy grading completeness, referral for laser photocoagulation, and glycaemic control review. Key informant interviews with 20 ophthalmologists, optometrists, and diabetic clinic nurses examine screening pathway barriers and referral system quality. SPSS is used for quantitative analysis, and qualitative data are coded thematically. Available diabetic eye disease literature from both zones identifies infrequent fundoscopic examination, absent structured screening recall systems, and limited access to laser photocoagulation equipment as the principal clinical gaps. The International Clinical Diabetic Retinopathy Severity Scale and the NICE Diabetic Eye Screening Programme standards provide the evaluation framework. Findings will support both state eye hospitals in developing a replicable structured diabetic retinopathy screening protocol. Keywords: diabetic retinopathy, screening practices, ophthalmology, South East and South West Nigeria, sight-threatening complications.