Questionnaire

Name         Gender Age            Contact details Economic status  Low  Medium  High Education level  Primary  Secondary  Graduate and higher Duration of diabetes (years)       5 and below  6 - 9  9-14  15 and above Knowledge and attitude of the patients Do you know the that diabetes can cause eye disease Yes  No Should persons with diabetes go for regular eye examinations? Yes  No There is no need to visit ophthalmologist if a person his having diabetes under control Yes  No Timely treatment can prevent/ delay damage due to diabetes in eyes Yes  No Whom do you consult in the event of eye problem? (Knowledge of choice of healthcare professional in the event of eye problem) Ophthalmologist Yes  No Any specialist (Non-ophthalmologist) Yes No Optometrist Yes No General practitioner Yes No Knowledge of available treatment for diabetic retinopathy No treatment available Yes  No Modification of life style Yes  No Control of diabetes Yes  No Surgical procedures Yes  No Only medication Yes  No Alternative medical therapies Yes  No How often you go for eye examination (Practice of patients’) Monthly Once in six months Yearly This is the first time Any other specific details: Remarks: