Diabetic eye screening

Screening intervals

The screening service operates a call/recall system based upon the register of people with diabetes held in Scottish Care Information - Diabetes Collaborative (SCI-Diabetes).

All people with diabetes who are eligible for screening (except those with gestational diabetes) are offered appointments on the following basis to have their eyes screened for retinopathy:

Newly diagnosed with T2 diabetes

People who are newly diagnosed with T2 diabetes are invited to attend immediately for a screen. DES have a national requirement to contact newly diagnosed patients promptly as we consider a first screen vital to establish any changes to your eyes.  Unfortunately there can be contact from the screening department before you may have had a discussion with your healthcare practitioner about the diagnosis. This is unavoidable as the information comes to us directly from your GP when you have a test done. If you receive a communication from us in this manner, please speak to your GP in the first instance if you have any concerns or queries.

With Type 1 diabetes

All people with Type 1 diabetes who reach the age of 12 years are invited to attend immediately.

With diabetes and pregnant

All people with diabetes and are currently pregnant will be asked to attend every trimester during pregnancy. At the last trimester screening, dependent on your results, your annual/bi-annual return will resume for check ups.

Any signs of diabetic eye problems

Those who have been screened and the outcome showed any signs of diabetic eye problems will be asked to attend again for screening in a 12 month period.

No signs of any diabetic changes

Those who have been regularly screened and the last two outcomes were completely clear (i.e. no signs of any diabetic changes in both eyes and on both occasions) will only be asked to attend every 24 months, rather than every 12 months. For example, if you were screened in 2022 and 2023 and both tests were clear, your next return to screening will be in 2025.  This is in line with a change to the DRS Programme called Revised Screening Intervals which has been recommended by the UK National Screening Committee. It is a very safe and effective approach which prevents you from having to attend unnecessary screening appointments.

Diabetes in remission

When people are fortunate enough to be in a position where their clinician has advised them that their diabetes has moved into remission, this is not a reason to discontinue attending diabetic retinopathy screening. The reason for this is because any marker for diabetes prior to a change in diagnosis means that the individual remains at risk of developing associated eye problems.

Being diagnosed as in remission will not remove you automatically from the eye screening programme. You are of course entitled to opt out of screening if you wish.

If you require permanent exclusion from screening, this will need to be actioned by your GP and you should discuss the matter directly with them. Possible reasons for permanent exclusion from the screening programme on advice of your GP are:

• Total loss of vision
• Terminal illness
• Unfit for treatment as a result of disability. If you find that you are physically unable to attend the NHS screening programme, our recommendation is that you continue to regularly have optician review in the community. Please check with your local optician to see if they provide home visits to accommodate your needs. Make sure that you advise the optician that you are diabetic so that they are aware of the need to consider any diabetic changes to your eyes. This does not form part of the National Diabetic Eye Screening Programme but your optician can still refer you for specialist review should the need arise in relation to any concerns about your vision.
• Informed choice to opt out - a completed disclaimer form obtained from your GP or the DRS admin team is required. Please contact us to discuss.
• Under the age of 12 years
• Under the care of an ophthalmologist for the purpose of treatment, surveillance or detection of diabetic retinopathy. Please note that not all ophthalmology appointments include checks for detection of diabetic retinopathy, therefore if you are invited by DES to attend, this will not be duplication of appointments.

Screening during pregnancy

If you are pregnant and have already been diagnosed with Type 1 or Type 2 diabetes, you should be referred for additional diabetic eye screening during each trimester of your pregnancy.

This will usually result in the same examination at each visit, unless the grading outcome from the last appointment indicates a referral to an ophthalmologist for further investigation. If a referral is necessary, then the ophthalmology team will carry out further retinopathy checks until you are discharged back to the screening team for routine recall purposes.

Optical Coherence Tomography (OCT) scan clinics

These appointments are now part of screening which may previously have been carried out in an eye clinic appointment.

This type of appointment is required when your result from screening has indicated that you have a level of referable maculopathy present. You are referred to have this specialist exam carried out which entails a 3D scan of the back of your eye.

The appointment will be similar to your screening appointment as you will be required to have further retinal photographs taken and dilation. The 3D scan allows our specialists to ascertain if you have any swelling in the back of your eye which warrants treatment.

You will receive a letter indicating what the next outcome will be following your scan. This may be further monitoring by OCT or an appointment for treatment at the eye clinic.

Opting out of screening

You can make an informed choice about opting out of the National Diabetic Eye Screening Programme. There is a process which we must follow to ensure that you are aware of the risks involved when submitting a written request to opt out.

If you have decided that you do not want to participate, you can:

• contact us using the details above to request an opt out form
• or print out this Diabetic Eye Screening Opt Out form (pdf) and complete and return it to us in the post or to the department email. The form must be signed by the patient wishing to opt out of screening or a designated person who has power of attorney.

When we send you opt out forms, your patient record is suspended initially for 12 months at the date of posting, during which time we will not contact you to attend an appointment in screening. If we do not receive your signed opt out request, you will be invited to attend screening again, 12 months from the initial suspended date.

Once we receive a signed opt out request from you, we will automatically suspend your screening record for 3 years from the date of receipt of the form. After this time, we will contact you again to check that your decision to opt out is still in place. We will also send a copy of your decision to opt out to your GP team.

Please note that we cannot remove you from screening recall unless we have either a signed opt out form in place or the express authority from either your GP or clinician involved in your diabetes care who can make an informed decision with regard to the implications of not attending a screening appointment.