Diabetic eye screening pathways: patient, grading, referral, surveillance

This document sets out an overview of the operational pathways in the NHS Diabetic Eye Screening (DES) programme.


Diabetic eye screening pathway overviews

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email Please tell us what format you need. It will help us if you say what assistive technology you use.


This publication illustrates, step by step, the diabetic eye screening working processes.

The document includes the:

  • retinal screening patient pathway
  • referral pathway from screening to slit lamp biomicroscopy surveillance
  • referral pathway from screening to digital surveillance
  • referral pathway from screening or surveillance to hospital eye services for diabetic retinopathy management
  • single common grading pathway
  • pathway for pregnant women
Published 29 October 2012
Last updated 2 October 2017 + show all updates
  1. Updated pregnancy flowchart.
  2. Updated edition of pathway overviews document.
  3. First published.