Diabetic eye screening 1

Why eye screening is needed

Diabetic eye screening is a key part of diabetes care. People with diabetes are at risk of an eye problem called diabetic retinopathy. This can lead to sight loss if it's not treated.

Diabetic retinopathy is one of the most common causes of sight loss among adults.

It occurs when the small blood vessels in the part of the eye called the retina are damaged.

You should still see your optician every 2 years for an eye test. Diabetic eye screening is only for diabetic retinopathy and does not check for other eye problems.

Screening can spot the diabetic retinopathy before you notice any changes to your vision. It doesn't usually cause any symptoms in the early stages.

If it’s found early enough, treatment may stop it getting worse.

It can be much harder to treat if it’s not found until it causes symptoms.

The test takes about 30 minutes and involves looking at the back of the eye and taking pictures of it.

When diabetic eye screening is offered

Everyone with diabetes who is 12 years of age or over should be invited to have their eyes screened once a year.

You should receive a letter from your local Diabetic Eye Screening Service asking you if you want to have a screening test. The letter will include a leaflet about diabetic eye screening.

People with diabetes can opt out of the screening programme if they choose. They should confirm this in writing to the screening service that has asked them to have screening

Contact your local screening service or your GP if you haven't had a letter and your screening test is overdue. You can look up your local screening service – your service will be the one nearest to your GP practice.

The letter will say where you need to go. This may be your GP practice, your local hospital, a local opticians, or a nearby clinic.

Bring all the glasses and contact lenses you wear, along with lens solution for contacts.

If you have sight problems in between screening tests, such as sudden vision loss or a vision that’s getting worse, seek urgent medical advice. Don't wait until your next screening test.

Diabetic eye screening in pregnancy

If you have diabetes and become pregnant, you'll need special care as there are risks to both mother and baby linked with the condition.

You'll be offered extra eye checks at or soon after your first antenatal clinic visit, and also after 28 weeks of pregnancy.

If the early stages of retinopathy are found at the first screening, you'll also be offered another test between 16 and 20 weeks of pregnancy.

If serious problems are found at any screening, you'll be referred to an eye specialist.

Some women who don't have diabetes can develop high blood sugar during pregnancy. This is known as gestational diabetes.

Pregnant women who get gestational diabetes aren't asked if they want to have diabetic eye screening.

What happens during diabetic eye screening

The screening appointment should last about 30 minutes.

When you arrive, the test will be explained to you. If you have any questions, ask the person who is treating you.

You'll be given eye drops to make your pupils bigger, which takes between 15 and 20 minutes, and pictures of your retina will be taken.

There will be a flash of light each time a picture is taken, but the camera won't touch your eye. Although the light is bright, it shouldn't hurt.

The eye drops may cause your eyes to sting slightly, and after about 15 minutes your vision will be blurred. You may find it hard to focus on objects that are close to you.

The blurring can last 2 to 6 hours. You won't be able to drive home after the test, so you may want to bring someone with you.

After the test, you may also find that things looks very bright. You may want to take a pair of sunglasses to wear on the way home.

Side effects

In very rare cases, the eye drops can cause a sudden pressure increase within the eye. This needs to be treated quickly at an eye unit.

The symptoms of a pressure increase are:

  • pain in your eye
  • redness of the white of your eye
  • blurred vision, sometimes with rainbow halos around lights, which doesn’t get better in a few hours

If you experience any of these symptoms after screening, go back to the screening centre or your nearest A&E department.

Your screening results

Within 6 weeks, both you and your GP should get a letter letting you know your results.

You won't get the results straight away, as the pictures need to be studied carefully.

The screening results may show either:

  • no retinopathy
  • background retinopathy – also called stage 1 retinopathy
  • degrees of referable retinopathy – this means retinopathy that requires referral to an eye specialist for further tests and treatment

You may need to have further tests if:

  • the pictures aren't clear enough to give a result
  • you have retinopathy that could affect your sight and treatment is needed
  • you have retinopathy that needs to be checked more than once a year
  • other eye conditions are found, such as glaucoma or cataracts

If your results show no retinopathy or background retinopathy, you'll be asked to come back for another screening test a year later.

You can also reduce your risk of getting diabetic retinopathy in the future by controlling your blood sugar levels and blood pressure.

Read more about preventing diabetic retinopathy.

If screening finds a problem that could affect your sight, you'll be told about the types of treatment that can help.

Read about the treatment options for diabetic retinopathy.

If you have questions about your results, contact your local diabetic eye screening service. Their details should be on the letter you got from them. You can also search for your local screening service.

Private screening

Eye checks for diabetic retinopathy are available privately but they might not be as good as the NHS Diabetic Eye Screening Programme.

If you're thinking about private screening, check that the company is properly regulated and ask for clear written information about the benefits as well as the risks of any tests offered.

Read more in the UK National Screening Committee's leaflet on private screening.

More information about diabetic eye screening

For more information, the Diabetic Eye Screening Programme has guides about:

The GOV.UK website also has diabetic eye screening leaflet.