Diabetes is a common condition in the UK, and retinopathy may be present in up to 90% of people who have had the disease for 20 years or more. It is the most common cause of blindness in the working population, but is amenable to treatment if initiated at the appropriate stage.
Before the introduction of the National Service Framework on Diabetes, retinopathy screening was accomplished by a number of delivery systems, or a combination of systems to suit local circumstances. These systems included:
* GP ophthalmoscopy as part of a diabetic clinic
* Hospital based indirect ophthalmoscopy
* Optometry based direct or indirect ophthalmoscopy
* Hospital based cameras
* Mobile cameras
* Optometry based cameras
Diabetic retinopathy monitoring tended to be the most common optometric co-management scheme with audits showing them to be clinically effective. Digital imaging, now recommend by the National Service Framework on Diabetes, according to strict, quality assurance standards, is now the standard form of diabetic retinopathy screening. One of the main advantages of such an approach is the ability it affords for auditing the outcomes. Whilst the National Screening Committee accepted that optometric slit-lamp biomicroscopy schemes operated well, it has nevertheless replaced those schemes with digital imaging systems, which can be provided in a number of ways, including from optometric practices. Please click on the menu to the left of your screen for additional information; also on the pdf documents at the bottom of this page.
An article published in OT on 12 January 2007 entitled 'Diabetic retinopathy - how to get involved in the national programme' is also available in pdf format at the bottom of the page. This article was written by Dr Susan Blakeney, Optometric Adviser to the College of Optometrists and Dr Deborah Broadbent, who is the Training and Education Lead for the English National Screening Programme for Diabetic Retinopathy and the Director of Diabetic Eye Screening at the Liverpool Diabetes Eye Centre.
Patient Information on Cessation of Optometric Screening Services
Some PCTs have chosen to abandon established diabetic retinopathy screening services which utilised the skills of community optometrists in favour of mobile systems, thus excluding the profession. The AOP has drafted a standard letter which can be adapted to local requirements, to help practitioners advise their patients of the importance of having regular sight tests and of being screened for diabetic retinopathy. This letter is amongst the pdf documents at the bottom of this page.
AOP Advice on Diabetic Screening
The AOP's advice on diabetic screening, is also available in pdf format below. This advice also deals with the option of offering a private diabetic eye check to patients who do not wish to remain in the national programme, for whatever reason. We point out that the word ‘screening’ ought not be used to describe this private service, since ‘screening’ now implies a process that is quality assured to specific standards.
