Diabetic retinopathy

• No retinopathy — there is no diabetic retinopathy visible, but we’ll continue to monitor this at each visit.
• Background retinopathy — (also known as mild non-proliferative diabetic retinopathy - NPDR) — we can detect small changes to your blood vessels, usually seen as tiny bulges in the walls of the blood vessels supplying the back of your eyes. These can also bleed easily due to the weakening of the blood vessel walls, so some small haemorrhages may be detected. Your eyesight isn’t usually affected at this stage. Your optometrist will advise on the next examination interval.
• Pre-proliferative diabetic retinopathy (also known as referable retinopathy) — we can see more severe and more widespread damage to the blood supply of the retina and there is a higher risk that your eyesight could be affected. You may at this stage be referred to a diabetic eye clinic to decide on how to reduce any further deterioration to the blood supply.
• Proliferative diabetic retinopathy (PDR) – This is where, as a result of the poor blood supply at the back of the eyes, new vessels have formed to try and compensate for the reduced blood flow in the usual retinal blood vessel network. These new vessels are fragile and can bleed significantly and there may also be scar tissue formed on the retina which can lead to more serious sight-threatening problems such as retinal detachments. At this point there is a very high risk you could lose your eyesight and referral for potential treatment would be offered in order to try and stabilise your vision, however at this stage any vision which is already lost is unlikely to be restored.
• Diabetic maculopathy — This is a form of diabetic retinopathy that occurs when the vessels supplying the central part of the retina, which is responsible for our central vision and seeing fine detail, become blocked or leak fluids, fats and proteins. At this point there is a significant chance that your eyesight will be affected, and it can impact your ability to read or see fine detail. Referral to a diabetic eye specialist would be necessary to determine if any treatment is indicated or for further monitoring.

Diabetic eye screening

Diabetic eye screening is separate from your normal eye test, so you’ll still need to see an optometrist regularly. Along with testing your vision, your optometrist will also be able to check for any signs of diabetic retinopathy during your eye test. One way of doing this is with an OCT scan, that allows us to see all the layers within the eye and helps optometrists to see any slight change in the retina that could signal diabetic retinopathy.

Following a diabetic eye screening appointment, the photos from your screening will be assessed by a number of specialists, including someone who is trained in identifying and grading retinopathy.

You may need to have a further assessment if:

• The photographs are not clear enough to give an accurate result
• You have retinopathy that could affect your sight and follow-up treatment or further assessment is needed
• You have retinopathy that needs to be monitored more closely and checked more than once a year
• Other eye conditions are detected, such as glaucoma or cataracts
• If your results show no retinopathy or background retinopathy, you will be invited back for another screening appointment at the recommended screening interval.