Antalet patienter med sjukdomen diabetes förväntas öka vilket kommer innebära att ett ännu större antal patienter behöver screenas för att upptäcka diabetesretinopati. Syftet med den här pilotstudien var att beskriva patienters erfarenheter av screening för diabetesretinopati på en ögonmottagning. Pilotstudien utformades efter en kvalitativ induktiv ansats och data samlades in genom semistrukturerade intervjuer. Materialet bearbetades genom kvalitativ innehållsanalys. De huvudkategorier som framkom var: trygghet, informationens betydelse, tillgänglighetens betydelse, oro för undersökningsresultatet och dess konsekvenser samt obehagligt och tidskrävande. Resultatet visade på att det var viktigt för informanterna med screening för diabetesretinopati. Det var en trygghet att få gå på kontroller för att upptäcka komplikationer i tid. Det framkom att de kände en oro för att utveckla diabetesretinopati och vilken påverkan detta skulle ha på deras livssituation. Informanterna ville få ett tydligare resultat från undersökningen och att tillgängligheten förbättrades.  Det behövs vidare omvårdnadsforskning kring information, kunskap och ökad tillgänglighet vid screening för diabetesretinopati. Sådan forskning kommer att vara till hjälp för att förstå och därmed hitta strategier för att förbättra omvårdnaden för patienter med diabetes samt för att nå ut till dem som uteblir från screeningen för diabetesretinopati. / The number of patients with the disease diabetes expects to increase, which means that even a larger number of patients will need to be screened to detect diabetic retinopathy. The purpose of this study was to describe the experiences of screening for diabetes retinopathy at an ophtalmology department. The pilotstudy was developed by a qualitative inductive approach and data were collected through semi-structured interviews. The material was processed by qualitative content analysis. The main categories that emerged were: security, the importance of information, the importance of accessibility, concerns about the result and its consequences and uncomfortable and time-consuming. The result showed that screening for diabetes retinopathy was important for the informants. It was a security to check their eyes to detect complications in time. It was revealed that they felt a concern for complications due to diabetic retinopathy and what effect this would have on their lives. The informants wanted to get a clearer result of the examination and that the availability would improve. Further nursing research about information, knowledge and increased availability in screening for diabetes retinopathy is needed. Such research would be helpful to improve care patients with diabetes, and to find strategies for reaching out to those who fail to attend screening for diabetes retinopathy.

The retina is a highly metabolically active tissue with large demands on the supply of nutrients. Disorders affecting the retina often include some vasculopathy with an impact on retinal circulation. Studies of retinal haemodynamics could thus help to detect, differentiate and diagnose diseases, to monitor changes in disease as well as progression and efficiency of the therapy. The present studies were an attempt to validate and determine the clinical usefulness of a newly developed technique for studying the retinal circulation in human eyes. We used different techniques to evaluate different parameters of retinal circulation. We examined how leukocyte velocity determined with Blue Field Simulation and transit times, mean transite time (MTT) and arterio-venous passage (AVP), and vessel diameter, determined from fluorescein angiograms, together reflects the retinal circulation. MTT was determined with a method based on an Impulse-Response technique, MTTIR. In a study on monkeys we compared our method, together with two conventional methods, with an absolute measurement of retinal blood flow (RBF) determined with labelled microspheres. There was a weak, but not statistically significant, correlation between retinal blood flow and MTTIR (r2 = -0.60, p = 0.06), but no useful correlation between retinal blood flow and either of the other two measures of transit times. In a study on healthy eyes we determined the effect of a physiological provocation, changes in arterial blood gases, on retinal circulation. Breathing pure oxygen or increased level of carbon dioxide in inspired air had no effect on MTT, but oxygen reduced leukocyte velocity and vessel diameter and carbon dioxide increased leukocyte velocity significantly. We concluded that unchanged transit time trough the retinal tissue was not due to a lack of effect of the gas provocation but a result due to concomitant changes in volume and flow. In a study on eyes of patients with diabetic retinopathy we investigated the relation between the extent of retinal circulation changes and the severity of the diabetes retinopathy (DRP). Transit times were relatively unaffected until proliferative DRP (PDRP) developed. In eyes with PDRP both MTTIR and AVP were increased. After panretinal photocoagulation treatment MTTIR returned to normal levels and vessel diameters tended to decrease while leukocyte velocity and AVP remained unchanged. We concluded that the increase in MTTIR in eyes with PDRP is at least partly explained by vessel dilation, causing an increased volume of the retinal vascular bed.

While architects think and work in a visual way, people who are visually impaired may pay more attention to other senses and are able to appreciate other spatial qualities. In my thesis project, I have explored architecture for the visually impaired. The idea is rooted in a frustration of that architecture is almost always valued visually. All other senses are mostly ignored - or at least never prioritised. What is architecture based on other senses than sight? If architecture is experienced by all senses - mustn’t architects involve all senses in their design process? In this project, the aim has been to create architecture that improves the visitors’ spatial perception by activating all senses as an experience and a source of information.