Screening for diabetic eye problems is a key part of diabetes care. People with diabetes are at risk for diabetic retinopathy (damage to the retina caused by diabetes). Diabetic retinopathy is a disease that, if not treated early, can lead to blindness.
Diabetic retinopathy is one of the most common causes of vision loss among people of working age.
This condition occurs when diabetes affects the small blood vessels and damages the retina. When blood vessels in the central part of the retina (the macula) are damaged, it is called diabetic maculopathy (damage to the macula due to diabetes).
It is important to note that people with diabetes should see their optometrist for regular eye exams every two years. Diabetic eye screening is specifically designed for diabetic retinopathy and is not used for other eye problems.
This article includes the following:
Why is eye screening needed?
When is eye screening needed?
Eye screening during pregnancy
What is the screening process like?
Results
Private screening
Why is eye screening needed?
Screening is a way to detect the disease in its early stages, before you notice any changes in your vision. Diabetic retinopathy often has no noticeable symptoms in its early stages.
If retinopathy is detected early, timely treatment can prevent it from getting worse. Otherwise, symptoms of the disease appear over time and can be very difficult to treat. For this reason, this article has tried to introduce the screening program for eye problems in diabetes.
It is recommended that everyone 12 years of age and older with diabetes undergo a screening test at least once a year. Diabetic retinopathy is very rare in diabetic children under 12 years of age.
This test takes about half an hour and involves an eye specialist or optometrist examining the back of the eye and taking pictures of the retina.
When is eye screening needed?
As previously stated, everyone aged 12 and over with diabetes should have a screening test at least once a year.
To have a screening test, you should receive a letter from the Diabetes Eye Screening Service, which will come with a leaflet about the screening test.
People with diabetes can opt out of the screening programme they have chosen. They must tell the Screening Service in writing that they want to have the test.
If it is time for your test but you have not received a letter, contact your local screening service or GP. The service that is relevant to you will be located in the nearest area to your GP surgery.
Your referral letter will tell you which centre you should go to for the test. You may need to go to a general surgery, local hospital, local ophthalmologist or the nearest clinic to where you live.
When you go, make sure to bring your glasses or contact lenses and contact lens solution.
If you have vision problems - such as sudden vision loss or decreased vision - between your screening tests, see your doctor immediately and don't wait until your next eye exam.
Screening for eye problems during pregnancy
If you have diabetes and are pregnant, you need special care, as both the mother and baby are at risk.
In this case, you will need to have further tests for diabetic retinopathy very soon after your first prenatal visit and also at 28 weeks of pregnancy.
If early stages of retinopathy are detected during your first screening test, you will need to have another test between 16 and 20 weeks of pregnancy, in addition to the tests listed above.
If any screening shows serious retinopathy, you will be referred to a specialist.
Some women who do not have diabetes develop hyperglycemia (high blood sugar) during pregnancy, which is called gestational diabetes.
Women who have gestational diabetes do not need to be screened for diabetic retinopathy.
What is the screening process like?
The screening test takes about half an hour.
When you arrive at the center, the screening test process will be explained to you, and you can ask your specialist if you have any questions.
Then, pupil-dilating drops are put into the eyes, and after about 15 to 20 minutes, pictures of the retina are taken.
During each photo, a light is seen, but the camera does not make contact with the eyes; although this light is clear, it should not be painful.
After the drops are instilled into your eyes, you may feel a slight stinging sensation, and after about 15 minutes, your vision will become blurry. You may have difficulty focusing on objects that are close to you.
Depending on the type of drops used, the blurred vision will last between two and six hours. You will not be able to drive after the test, so it is best to bring someone with you.
After the screening process, you may feel that everything around you is very clear. In this case, it is best to wear sunglasses.
Side effects
In very rare cases, eye drops can cause a sudden increase in pressure in the eye. If this happens, you should seek immediate treatment in an eye care unit.
Symptoms of increased pressure in the eye include:
Severe pain or discomfort in the eye
Redness of the whites of the eyes
Permanent blurred vision, sometimes with rainbow halos around the light bulb
If you experience any of these symptoms after the test, return to the screening centre or, if this is not possible for you, go to the nearest emergency department.
Screening results
Within 6 weeks, you and your GP should both receive a letter with the test results.
You will not receive the results straight away, as the images need to be reviewed by several specialists, particularly a specialist in retinopathy.
The screening result could be one of the following:
No retinopathy (no retinopathy seen)
Intrinsic retinopathy, also called stage 1 retinopathy.
Degrees of retinopathy that require referral. This means that for this type of retinopathy, you should see an eye specialist for further testing, evaluation, and treatment.
You may need further evaluation if:
The image is not clear enough to provide an accurate result.
You have retinopathy that could affect your vision and therefore requires further treatment.
You have retinopathy that needs to be checked more than once a year.
Other eye diseases have been diagnosed, such as glaucoma (a group of eye diseases that affect a person’s vision) or cataracts (clouding of the lens of the eye).
If the test results show no evidence of retinopathy or if you have underlying retinopathy, you will be asked to return for another screening test next year.
You can reduce your risk of developing diabetic retinopathy by controlling your blood sugar and blood pressure.
If the screening results show that diabetic retinopathy or maculopathy (damage to the macula) is threatening your sight, you will be told how far the disease has progressed, which will determine your course and type of treatment.
If you have any questions about your test results, contact the Diabetes Eye Screening Service. Details of this should be on the letter you receive from them.
Private screening
Eye tests for diabetic retinopathy are also carried out in private settings, but they are not necessarily of the same quality as those offered by the NHS Diabetes Eye Screening Programme.
If you are considering having a screening test done at a private center, carefully check that the center operates according to sound diagnostic and therapeutic principles and ask them for a clear, written explanation of the benefits and risks of the tests.