; Diabetic retinopathy is the commonest cause of blindness in the 30-
65 age group in the UK at the present time.
; Development or progression of retinopathy can be prevented by good
glycaemic control, management of hypertension and avoidance of
; It is reasonable to aim for a target HbA1c of < 7.0% to limit
development and progression of microvascular complications,
; Laser treatment is indicated for proliferative diabetic retinopathy and
maculopathy. It is more likely to be effective if applied at an early stage
when the patient is more likely to be asymptomatic; therefore screening for
retinopathy is vital.
; Laser therapy is not always effective in all patients
; Retinopathy may be present in up to a third of newly diagnosed type 2
; Some degree of retinopathy will also be present in the majority of patients
who have had diabetes for more than 20 years, and a significant number,
particularly if poorly controlled, will develop retinopathy at an earlier stage.
; All patients over the age of 12 years should have an annual eye
examination. This will be retinal photography performed by an Optometrist
or other qualified screener
; Patients with proliferative retinopathy, maculopathy, unexplained loss in
visual activity, cataract affecting vision, or where the doctor has other
concern should be referred to an Optometrist or Ophthalmologist
All patients should have their eyes examined at least annually
for detection of diabetic retinopathy
HOW TO PERFORM RETINAL ASSESSMENT IN DIABETES
; Examine visual acuity on Snellen Chart with the patient wearing
spectacles if appropriate.
; If acuity is reduced, check if it corrects with a pinhole.
; Examine near vision with patient’s reading glasses. This is more sensitive
for detecting maculopathy.
; Warn patient that drops may blur his/her vision for a few hours and that it
is preferable that he/she should not drive a car during this time.
; Dilate pupils with 1% Tropicamide.
WESTERN ISLES NHS
ANNUAL EYE SCREENING
Normal Retina or Diabetic Retinopathy/Maculopathy or other Minimal Background Pathology Diabetic Retinopathy
Direct Referral to Repeat Referral to GP Ophthalmologist Examination at