People living with diabetes should have a diabetic eye check — eye screening — as part of their diabetes checks. This is because diabetes can lead to eye problems, such as diabetic retinopathy. So if you are invited to a screening appointment it's really important to attend.
A diabetic eye check is different to a normal sight test appointment. Photos are taken of your eyes to see how diabetes is affecting them.
If your most recent screening test result showed no signs of retinopathy, this means you are in the group of people with diabetes who are lowest risk of retinopathy. Evidence gathered over several years shows it is now safe for you to wait up to 24 months between screening appointments. There is very little chance you will develop sight-threatening retinopathy between appointments.
Find out why some people miss out on a diabetic eye check and our tips for getting one.
If you notice any changes to your eyesight, these should be checked as soon as possible – gradual changes can be checked by your optician, but if you notice any sudden changes get urgent medical care.
Preventing eye problems
Eye screening — sometimes called a diabetic eye check — is normally carried out at least once a year or every two years if your last two screenings were clear. There is good evidence to show that it is safe for people with no retinopathy to wait longer between screenings.
We’ve also got lots of information to help you keep your eyes healthy during this time, so you can prevent eye complications from developing.
If you do notice any changes in your vision, it’s important that you call your GP straight away and explain your situation. If you can’t get through, call 111 for advice.
Why is diabetic eye screening important?
Eye screening is an important part of managing your condition, regardless of the type of diabetes you have. This is because having diabetes can mean you’re more at risk of developing eye problems, such as diabetic retinopathy. This can sometimes lead to sight loss.
As diabetic retinopathy doesn’t show any symptoms in the early stages, it can become quite advanced before you start to notice it. Going to your routine eye screening can help you spot and treat diabetic retinopathy early, which should prevent it from progressing to a stage where it’s more difficult to treat.
What is eye screening?
Eye screening is a way of spotting eye problems before you notice any changes to your sight.
Everyone living with diabetes over the age of 12 will get an invite for regular eye screening. Eye problems are very rare in children younger than 12 years old, so that’s why they don’t automatically get this check.
At first, the screening should be every year, then this can change depending on your results.
At your eye screening, your healthcare professional will look for signs of eye disease caused by your diabetes. The aim of your regular eye screening is to catch any issues early on. This way you can get the treatment you need in time.
It’s important to know that this type of eye screening isn’t the same as a regular eye test with an optician. You still need to have regular eye tests, as they check for lots of other problems.
What happens at a diabetic eye screening?
You will start by having a quick check of your eyes, which will be followed by the main part of the eye screening. This is when the back of your retina is photographed.
You may get eye drops to make your pupils bigger. These eye drops may sting, but the screening as a whole should not be painful. Your vision will be blurry after the drops, and you will find this makes it difficult to focus on objects close to you. This can last for up to six hours, so it’s a good idea to bring someone with you to take you home. You may also find that everything seems brighter than usual, so you may want to bring sunglasses for after the screening.
You'll have photos taken of each eye and both times there will be a flash of light. Your eye won't be touched by the camera and you shouldn't experience any pain.
While it’s important to have an eye screen, you can choose not to have it. But we recommend that you do. It's part of your routine checks and could help you avoid serious complications.
Every year, more than 1,300 people with diabetes have sight loss that could have been picked up and prevented.
That’s 25 people a week.
Understanding diabetic eye screening results
You will get a letter with your results from your eye screening within six weeks. When you get them you will see an 'R' followed by a number. The R stands for retinopathy and the number tells you how much damage, if any, has been done.
Depending on what your results say, you will have different steps to follow.
Your results | Your next steps |
No retinopathy (R0) | Continue your regular eye screening |
Background changes (R1) | You may be asked to return sooner |
Non-proliferative retinopathy (R2) | More regular eye screenings |
Proliferative retinopathy (R3) | You will be seen by an eye specialist quickly and taken through your treatment options |
You might also see an 'M' which stands for maculopathy. This is when fluid builds up in part of your eye. Once again there will be a number which will tell you your result. This will indicate if you need to be screened more regularly and, if necessary, referred to an eye specialist.
Some people with small changes in their eyes seen on the retinal photo, will now be asked to have a follow-up eye scan to get a detailed picture of the layers in the back of the eye.
The scan – called Optical Coherence Tomography (OCT) - takes a few seconds and is painless. It takes a 3D image of your eye and can detects changes to the eyes the photos might miss, such as a thickening of the retina.
The scan gives more accurate results and will help to detect problems sooner as well as help your diabetes team decide whether you need to be referred to a hospital eye clinic or not. This means people with diabetes who have eye problems detected by an OCT scan can be treated more quickly.
In England, the OCT eye scan is being introduced into diabetes eye screening clinics now, and the aim is it should be offered to all people with changes in their macular by October 2025. The OCT scan is already available in Scotland.
If you’re not sure what the results mean or have any questions about what to do next, speak to your local eye screening service. Make a note of the results and get to know what they mean - it’s important that you understand any changes and what you can do to prevent them getting worse.
You are more likely to reverse any eye damage if you find it early on. That is why going to regular eye screening appointment is essential.
Looking after your eyes
Your regular eye screening will help you keep track of how your eyes are doing. But there are steps you can take to reduce your risk of developing serious complications too. These include:
- looking out for any changes to your sight e.g. floaters, dimmer vision, struggling to see in the dark
- knowing your target blood sugar levels
- keeping on top of your blood pressure and cholesterol levels
- eating a healthy diet
- being active
- giving up smoking.
If you do start to develop eye problems, your healthcare team can support you and talk to you about your treatment options. It’s important to remember that you can prevent them from getting worse if they’re spotted early enough.
