Guidance

Diabetic eye screening

Updated 4 August 2022

Public Health England (PHE) created this information on behalf of the NHS. In this information, the word ‘we’ refers to the NHS service that provides screening.

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Diabetic eye screening is recommended by the NHS.

1. Purpose of screening

Diabetic eye screening checks for signs of diabetic retinopathy and other eye problems caused by diabetes and monitor the health of your eyes if you are pregnant and have type 1 or type 2 diabetes.

Some women develop gestational diabetes in later pregnancy (28 weeks or more). Gestational diabetes can be treated through changes in diet and usually goes away once the baby is born. You will not be offered diabetic eye screening if you develop gestational diabetes.

2. About this condition

Diabetic retinopathy is caused when diabetes affects the small blood vessels in the retina at the back of the eye. Everyone with diabetes is offered eye screening but screening is very important when you are pregnant because the risk of serious eye problems is greater.

3. The screening test

You will be offered screening at, or soon after, your first antenatal clinic visit and also after 28 weeks of pregnancy. If early stages of retinopathy are found at the first screening, you will be offered another test between 16 and 20 weeks of pregnancy. If significant retinopathy is found at any screening, you will be referred to an eye specialist.

The screening test during pregnancy is the same as routine screening at all other times.

Screening staff will record your details and level of sight. They will put drops in your eyes to make your pupils larger so the retinas can be seen more clearly. They then take digital photographs of your retinas.

If the images are not clear enough you will be referred to an eye specialist for a different test.

4. Safety of the test

The photograph is painless and the camera does not come into contact with the eye. The eye drops may sting for a few seconds and cause blurred vision for 2 to 6 hours after the test. Take all your usual spectacles with you.

Take sunglasses with you to wear home, as everything may look very bright after the screening test.

Arrange to use public transport or get a lift for the journey home. You should not drive after screening as the eye drops can blur vision.

Very rarely, the drops can cause a sudden, dramatic rise in pressure within the eye. Symptoms of pressure rise include:

• pain or severe discomfort in the eye
• redness of the white of the eye
• constantly blurred sight

If you experience any of these symptoms after screening, you should return to the eye unit or go to an accident and emergency department.

5. Screening is your choice

This test is strongly recommended if you already had diabetes before getting pregnant.

Eye screening is a part of managing your diabetes and diabetic retinopathy is treatable, especially if it is caught early.

6. Not having the test

People with diabetes can decide not to attend eye screening appointments.

If you decide not to have the test you should notify the clinician looking after your diabetes care during pregnancy.

7. Possible results

If you have the screening test, possible results are:

• no retinopathy
• early signs of retinopathy
• more serious retinopathy that requires referral to a specialist

If your test shows early signs of retinopathy, your health professional will give you advice about looking after your diabetes during pregnancy. You would then be invited for additional screening tests during your pregnancy. If you are a smoker, seek help to stop or at least cut down.

If the test shows you have referable retinopathy you will receive an appointment with an eye specialist.

8. Getting my results

A letter will be sent to you and your GP within 6 weeks following your screening appointment.

Find more information and details of support groups on NHS.UK.