Acute Angle Closure Incidence in a Large Countywide Safety Net Teleretinal Screening Program: Safety of Pharmacologic Dilation in Diabetic Retinopathy Screening
Pharmacologic pupillary dilation in large-scale teleretinal diabetic retinopathy screening programs carries an extremely low risk of triggering acute angle closure (AAC), with incidence rates less than 1 in 40,000 dilations.
Manual review of International Classification of Diseases (ICD) codes for AAC demonstrates high fidelity in case identification within electronic health record systems.
All confirmed AAC cases post-dilation occurred in female patients with predisposing risk factors such as anatomically narrow angles, underscoring the value of targeted risk assessment.
Findings advocate reconsideration of AAC risk as a contraindication to routine dilation in safety net populations, facilitating better screening uptake and earlier detection of retinal disease.
