Synopsis
Detect sight-threatening diabetic retinal disease before vision is lost, distinguish screening from diagnostic eye care, and coordinate timely ophthalmic treatment while improving systemic risk safely.
- Diabetic eye screening detects retinal change in people who may still see normally; it does not replace a routine sight test or assessment of new visual symptoms.
- The English programme invites eligible people with diabetes from age 12, excluding gestational diabetes alone; pathways and intervals differ across UK nations, so verify the local programme.
- Background non-proliferative disease reflects microaneurysms, haemorrhages and exudates, whereas proliferative disease is defined by retinal or disc neovascularisation and threatens vitreous haemorrhage and tractional detachment.
Key red flags
New vessels at the disc or elsewhere, preretinal haemorrhage, vitreous haemorrhage or fibrous proliferation signals high risk of severe sight loss and needs timely ophthalmic treatment.
Investigation priorities
Screen eligible asymptomatic people for diabetic retinal and macular abnormalities.
Management branches
Eligible person with diabetes who has no acute visual symptom requiring diagnostic assessment.
- Confirm enrolment in the correct national programme, current contact details, accessibility needs and whether pregnancy or previous eye treatment changes the standard recall route.
- Explain dilation, temporary blur and driving implications; obtain quality-assured retinal photographs and ensure ungradable images enter the alternative assessment pathway.
Key medicines
Intravitreal anti-VEGF therapyAdminister by an ophthalmologist using the licensed loading and review schedule for the selected agent.
Intravitreal corticosteroid implantUse only the licensed ophthalmic implant and retreatment interval selected by the retinal service.