Diabetic Retinopathy Screening

Definition/Description

Diabetic eye screening is a test that looks for an eye condition called diabetic retinopathy that can be caused by diabetes. People living with diabetes may be at risk of developing an eye condition called diabetic retinopathy. Diabetic retinopathy can cause sight loss if it's not treated. Diabetic eye screening checks for signs of diabetic retinopathy, often before you notice any changes in eyesight. Finding and treating diabetic eye disease early can prevent or reduce damage to the eyes and prevent sight loss.

All people living with diabetes aged 12 years and older should be referred to the local Diabetic Eye Screening Programme either at diagnosis of diabetes or when registering with the GP practice. The Humber Diabetic Eye Screening Programme covers all people living with diabetes registered with a GP within Hull, North East Lincolnshire and North Lincolnshire plus the majority of GP Practices in East Riding of Yorkshire (excluding Pocklington, Driffield, and Bridlington). A monthly electronic data extract from the GP management system (GP2DRS) identifies the eligible cohort for invitation to screening.

Diabetic eye screening: use of personal information - GOV.UK

However, a formal GP practice referral to Humber Diabetic Eye Screening is helpful as the referral form contains additional information fields that can ensure the person being referred is booked into a suitable location to meet their needs, i.e. need for BSL interpreter, wheelchair accessibility, etc

Red Flag Symptoms

Changes to the sight in those with diabetes may be an indication of diabetic eye disease but may be due to many other causes. In most cases local community optometrists can assess and refer if appropriate. If any form of sight loss occurs, refer directly to the local Ophthalmology service which is: -

Hull and East Yorkshire Eye Hospital for patients living in Hull or most of East Yorkshire (excluding the Goole area).
Scunthorpe General Hospital for patients living in the catchment area
Diana Princess of Wales Hospital in Grimsby

Goole and District Hospital in Goole

Guidelines on Management

The NHS Diabetic Eye Screening Programme aims to reduce the risk of sight loss among people with diabetes by the early detection and treatment, if needed, of diabetic retinopathy (DR). Screening using digital photography is offered on a regular basis (dependent on patient’s current condition) to all eligible people with diabetes aged 12 and over. Due to recent changes to the Programme that have come into effect in the last couple of years (changes from yearly to 2 yearly reviews). This includes those who are in remission of diabetes (Type 2) and those with monogenic diabetes (MODY) but does not include those with gestational diabetes. DES_07_GP_information_sheet_March_2016.pdf

Patients will be sent information on the NHS Diabetic Eye Screening Programme and what to expect at a screening test with their first invitation letter. This information can be accessed here:

Good diabetes management can significantly reduce the occurrence of complications such as retinopathy. If retinopathy is developing support to lower HbA1C and/or improve time in range gradually is advised, as a rapid improvement in diabetic systemic control can cause rapid worsening of diabetic eye disease (“early worsening phenomenon”). Interim Guidance for Hybrid Closed Loops and GLP GIP Receptor Agonists - Vaccinations and Screening - Futures

Referral Criteria/Information

Do not Refer

If the patient is under the age of 12 years old
If the patient has gestational diabetes
If the patient has never been diagnosed or coded as having Diabetes Mellitus.

Referral Criteria

Any diagnosis of diabetes (including rarer sub-types) in people aged 12 years and older
Please ensure that any additional requirements are indicated so that an appropriate venue and support for needs can be arranged. Any changes for patient support occurring after referrals will also need to be updated to the service.
Patients with diabetes resolved or in remission still require lifelong screening

Referral Methods

Please see the below referral form. Complete and send by email to retinalscreening1@nhs.net
Discuss the referral with the patient and the importance of attending screening; leaflets are available in the additional information below.

People living with diabetes registered with a GP practice in Driffield, Pocklington or Bridlington should be referred to the North Yorkshire Diabetic Eye Screening Programme. - Diabetes - York - HNY Policy and Pathway Repository