This study will investigate the feasibility and acceptability of using Corneal Confocal Microscopy (CCM) for the early assessment of lower limb nerve damage. We will evaluate the practical ability of optometrists to capture good enough images to enable CCM tests to be done in clinical practice. We will evaluate patient and provider views of CCM and the type of training/support that optometrists require to capture images of good enough quality for analysis. We will compare how many patients have a positive CCM result (indicating nerve damage) with the diabetic eye test screening result and medical histories.
Results will include the percentages on: images of sufficient quality, patients who consent, patient who undertake successful screening. A combined cost-of-illness and budget impact analysis (BIA), will provide an assessment of the likely impact that that CCM screening tests would have on healthcare budgets. We will also assess the impact of early nerve damage diagnosis, treatment and outcomes. This will allow us to produce a cost-effectiveness analysis of the approach in practice. Heidelberg Engineering will also benefit by learning about the implementation of this technology in the community.