The NCL Diabetic Eye Screening Programme offers quality-assured diabetic eye screening to detect early signs of diabetic retinopathy in patients, involving digital photographs of the retina to identify changes before symptoms arise, with referrals to hospital eye services for treatment if needed.

Eligibility Criteria

Inclusions

• aged 12+ and have received a definitive diagnosis of diabetes
• diagnosis has been discussed with the patient
• patients aged <12 years may be referred to the programme, but they will not be invited for a screening appointment until after their twelfth birthday.

If there are specific concerns about any patients aged <12, in accordance with national guidelines these patients should be referred to be seen by paediatric ophthalmology consultants in a hospital eye clinic.

Exclusions

• patients who are terminally ill
• patients who are medically unfit, such as
  • those who are unable to sit still in front of a slit lamp
  • those who need transport on stretcher
  • those who need to be transferred from a wheelchair via a hoist
  • those who are bedbound and housebound
  • those with severe dementia
• patients with pre-existing conditions (e.g. people who will never be able to benefit from and/or receive treatment due to a pre-existing condition)
• patients with gestational diabetes, because:
  • patients with pure gestational diabetes do not seem to progress to any referable degree of diabetic retinopathy during their pregnancy and are therefore excluded
  • if a patient has gestational diabetes, but has possible pre-existing diabetes, then the patient needs to be registered by the GP as having diabetes; NCL DESP will then add the patient to the screening programme and screen the patient according to the national guidelines (see the NCL DESP gestational guidelines in Resources for further clarity)
• patients with Impaired Glucose Tolerance (IGT), including:
  • patients who have a result indicating IGT, borderline diabetes or pre-diabetes, and impaired fasting glycaemia are excluded.

Please note: 

• medically unfit patients must be excluded from screening by GPs completing a Certificate Of Unsuitability (COU), emailed to DESP (or complete a COU when asked by NCL DESP)
• if GPs would like a patient who is excluded from screening to be seen for a retinal examination, patients can be referred to hospitals ophthalmology department directly by the GP.

How to Refer